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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845873
Report Date: 09/08/2021
Date Signed: 09/08/2021 04:49:01 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:MANDUJANO FAMILY CHILD CAREFACILITY NUMBER:
334845873
ADMINISTRATOR:MANDUJANO,MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 641-6640
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY:14CENSUS: 0DATE:
09/08/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:08 PM
MET WITH:Maria MandujanoTIME COMPLETED:
04:50 PM
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On 09/08/2021, Licensing Program Analyst, Laura Mejorado and Destinee Hogue arrived at the facility to conduct a Case Management inspection to amend the citation report that was issued to the facility on 07/21/2021. LPA toured the facility, took census and met with Licensee Maria Mandujano. There were no children in care during visit, children left early for the day.

The following items were dismissed from the report:
1) Type B Section 102423(a)

An exit interview was held with Licensee Maria Mandujano.

A copy of this report must be made available for 3 years
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura MejoradoTELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
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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