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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360919094
Report Date: 01/07/2020
Date Signed: 01/07/2020 08:43:22 AM

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:PSD/SOUTH REDLANDS HEADSTART/STATE PRESCHOOLFACILITY NUMBER:
360919094
ADMINISTRATOR:DANIELA VARGAFACILITY TYPE:
850
ADDRESS:15 N. CENTER STREETTELEPHONE:
(909) 798-2690
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:68CENSUS: 47DATE:
01/07/2020
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
08:14 AM
MET WITH:Daniela VargaTIME COMPLETED:
08:55 AM
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On 01/07/2020 at 8:14am, Licensing Program Analysts (LPAs), Destinee Hogue and Sharleen Robinson, arrived at the facility to conduct a case management inspection regarding the Decision and Order dated 12/27/2019 and effective 01/06/2020. The Decision and Order is for the exclusion of an employee and excludes the employee for the remainder of the employee’s life.

During this inspection, LPAs toured the facility inside and out, conducted census, and discussed the Decision and Order with Daniela Varga. Ms. Varga signature below confirms that she received a copy of the Decision and Order dated December 27, 2019, effective January 6, 2020.

Ms. Varga understands that employee, Raymond Rivera is excluded for the remainder of their life and that the facility is to remain in full compliance with Tittle 22 Regulations. LPAs informed Ms. Varga that the department will conduct annual unannounced site inspections, to ensure compliance with the Decision and Order.

An exit interview was conducted, and a copy of this report was provided to Site Supervisor Daniela Varga. Ms. Varga understands a copy of this report must be made available to the public for three years. LPAs issued a Notice of Site Visit and verified that it was posted in a prominent location before leaving the facility.

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020
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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