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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844743
Report Date: 03/15/2022
Date Signed: 03/18/2022 09:09:07 AM


Document Has Been Signed on 03/18/2022 09:09 AM - It Cannot Be Edited

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:SCHOOL AGE CARE BY YOU'RE INVITED DOWNTOWNFACILITY NUMBER:
334844743
ADMINISTRATOR:JAMI WESTFACILITY TYPE:
840
ADDRESS:4495 MAGNOLIA AVETELEPHONE:
(951) 351-1023
CITY:RIVERSIDESTATE: CAZIP CODE:
92501
CAPACITY:37CENSUS: 11DATE:
03/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Sarah OhashiTIME COMPLETED:
04:00 PM
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On this date and time, Licensing Program Analysts (LPAs) Laura Mejorado and Destinee Hogue conducted a case management inspection to deliver an extended temporary relocation waiver. The purpose of today's inspection is to issue an extension to a Temporary Relocation Waiver which was originally approved on 08/19/2021 and rescinded on 09/17/2021, due to the facility not obtaining an approved fire clearance to temporary utilize Rooms 1-5 located at 4495 Magnolia Ave, Riverside, 92501. During this inspection, LPAs toured the facility inside and outside, took census, and reviewed the following information with Facility Representative Sarah Ohashi.

Director, Jami West, has requested an extension to a temporary relocation waiver to utilize alternative rooms at Calvary Presbyterian Church located at 4495 Magnolia Ave, Riverside, 92501, until repairs are completed in licensed Rooms A, B, and C. A fire inspection for temporary rooms 1-5 was conducted on 08/19/2021. On 09/21/2021, the Riverside Regional Office received an approved STD850 Fire Inspection Safety Request indicating Rooms 1-5 are cleared for usage by Riverside City Fire Department.

The previous waiver was valid from Tuesday, September 28, 2021 through Thursday, March 31, 2022. This waiver is valid from Friday, April 1, 2022 through Friday, July 1, 2022 which allows three (3) additional months for the renovation of the damaged facility. Measurements were previously taken on 08/19/2021.

Temporary Relocation Waiver Conditions:


1. Parent notification shall be given to all parents and/or authorized representatives. Consent forms shall be signed and kept in the children’s files.
2. There will be no commingling of the School Age Program children with the Church Congregation.
3. The children will have sole usage of the two bathrooms located on the first floor.
4. The Site Director or Lead Teacher will conduct daily monitoring to ensure compliance.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura MejoradoTELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SCHOOL AGE CARE BY YOU'RE INVITED DOWNTOWN
FACILITY NUMBER: 334844743
VISIT DATE: 03/15/2022
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5. The school age children shall have visual care and supervision, at all times.
6. The appropriate teacher-child ratio shall be maintained, at all times.
7. The facility will request another waiver prior to this waiver’s expiration date, if needed.
8. The facility shall remain in substantial compliance with Title 22 Regulations.

Failure to comply with the conditions of the waiver, may result in termination of the waiver. Facility agrees to provide the Department with updates regarding the completion and repairs of the licensed school-age Classrooms A, B, and C.

No deficiencies were cited during this inspection.

An exit interview was conducted, and a Notice of Site Visit was provided and must be posted for 30 days.

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura MejoradoTELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
LIC809 (FAS) - (06/04)
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