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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845765
Report Date: 10/28/2020
Date Signed: 10/29/2020 12:40:43 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:LISA D. STINSON HOMEWORK CLUBFACILITY NUMBER:
334845765
ADMINISTRATOR:LISA D. CARONNAFACILITY TYPE:
840
ADDRESS:44210 WARNER TRAILTELEPHONE:
(760) 972-7639
CITY:INDIAN WELLSSTATE: CAZIP CODE:
92211
CAPACITY:60CENSUS: DATE:
10/28/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Lisa CaronnaTIME COMPLETED:
03:30 PM
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Due to COVID-19 pandemic, on October 28, 2020. Licensing Program Analyst (LPA) Timeka Reed conducted a Tele-inspection. Due to the executive order issued by Governor Newsom on March 16, 2020 regarding COVID-19, this inspection was conducted via FaceTime application.

The purpose of the inspection was to tour the multipurpose room. Licensee will utilize the multipurpose room in addition to rooms F4 and F8 (inspected on 1/31/2020).

The multipurpose room is equipped with tables and chairs. There were no hazards observed on this date. Water fountains located inside the multipurpose room will not be utilized at this time due to current safety guidelines established by the Center for Disease Control and Department of Public Health as they relate to Covid-19.

Multipurpose room will only be utilized by children that are enrolled during hours of operation.

An exit interview was conducted and a copy of this report was provided to the applicant on this date.



A copy of this report must be made available to the public for 3 years
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020
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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