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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360904541
Report Date: 07/19/2021
Date Signed: 07/19/2021 01:25:18 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:AHRENS CHILD CARE CENTERFACILITY NUMBER:
360904541
ADMINISTRATOR:AHRENS, JOHN & KAYFACILITY TYPE:
850
ADDRESS:201 N. UNIVERSITY STREETTELEPHONE:
(909) 793-8601
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY:48CENSUS: 26DATE:
07/19/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:John AhrensTIME COMPLETED:
01:40 PM
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On 07/19/21 at 12:30pm Licensing Program Analyst (LPA) Justin Giese conducted a case management visit in response to the receipt of an Unusual Incident Report (UIR) that was received by the licensing agency on 07/09/2021. UIR indicates there was a possible personal rights violation at the facility.

LPA toured the facility, reviewed/obtained records and conducted interviews with the Director and Staff. Based on information gathered, the facility acted appropriately by immediately reported the alleged incident to Licensing and submitting LIC 624 Unusual Incident Report within seven days. At this time no violations of Title 22 have been identified.

No deficiencies have been cited. An exit interview was conducted, Notice of Site Visit issued, and a copy of this report was provided to the Director.

A copy of this report must be made available to the public upon request for 3 years.

SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin GieseTELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
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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