<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844604
Report Date: 03/11/2020
Date Signed: 03/11/2020 03:33:40 PM

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CEJA FAMILY CHILD CAREFACILITY NUMBER:
334844604
ADMINISTRATOR:CEJA, JASMINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 848-5001
CITY:COACHELLASTATE: CAZIP CODE:
92236
CAPACITY:14CENSUS: 0DATE:
03/11/2020
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:JASMIN CEJA AND CESAR HUAZANOTIME COMPLETED:
03:35 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On date and time listed, Regional Manager (RM) Reynauldo Pennywell, Licensing Program Manager (LPM) Aaron Ross and Licensing Program Analysts (LPAs) John Huynh and Elyse Jones conducted a meeting held in the Riverside Child Care Regional Office and met with Licensee, Jasmin Ceja and Applicant, Cesar Huazano. The conference focused on the following items:

1. Operation of a Family Child Care Home
2. Licensee's Responsibility and Department's Expectations/Goals.
3. Association, Roles and Responsibilities of adults/assistants in the home
4. Conduct Inimical
5. The licensee will submit a letter listing all adult individuals who currently resides in the home. In addition to submitting an updated Family Child Care Application (LIC 279) to the Department by 3/20/20.
6. Have property owner's submit a letter by 3/20/20 indicating that they do not reside in the home and that they understand if that changes, an updated LIC 279 will be submitted and the Department will be notified.


Licensee, Jasmin Ceja and Applicant, Cesar Huazano understood and agreed.

An exit interview was conducted, and a copy of this report was provided to the Licensee and Applicant.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: John HuynhTELEPHONE: (951) 529-2439
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1