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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842375
Report Date: 01/25/2022
Date Signed: 01/25/2022 10:26:22 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:VVUSD MEAD VALLEY ELEMENTARYFACILITY NUMBER:
334842375
ADMINISTRATOR:ANDREA RODICH-VITECKFACILITY TYPE:
850
ADDRESS:21100 OLEANDER AVENUETELEPHONE:
(951) 940-8530
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY:96CENSUS: 0DATE:
01/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH: Corby Warren - Site Director/ PrincipalTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Rachel Zeron conducted an unannounced case management visit to conduct an inspection for a temporary classroom change request. LPA met with Corby Warren, Site Director. An Letter from District was received on January 21,2022 to temporarily change classroom locations from classroom 2 to classroom 24 for the Preschool age program. Classroom 2 will be under construction until the end of the school year, approximately June 2022. The days and hours of operation will remain the same: Monday thru Friday from 7:00 AM to 6:00 PM.

Total children toilets and sinks and outdoor activity space remained the same, measurements did not change. Waiver in file for shared restroom and playground with elementary school. There was also no change in capacity, capacity remains at 96.
The following was observed:

Classroom was adequately equipped with age and size appropriate furniture and equipment
There was a sink and water fountain in the classroom.

Carbon monoxide detectors and smoke detectors are built into the HVAC system.

No deficiencies were cited.

An exit interview was conducted with Corby Warren. A copy of this report was provided. Notice of Site Visit was issued and must be posted for 30 days.



This report must be made available at the facility for 3 years for public review upon request
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Rachel ZeronTELEPHONE: (951) 782-4207
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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