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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
364810707
Report Date:
02/10/2020
Date Signed:
02/10/2020 04:26:31 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:
MOUNT ZION CHRISTIAN SCHOOL
FACILITY NUMBER:
364810707
ADMINISTRATOR:
BARABARA YOUNG
FACILITY TYPE:
850
ADDRESS:
224 A W. CALIFORNIA STREET
TELEPHONE:
(909) 988-2280
CITY:
ONTARIO
STATE:
CA
ZIP CODE:
91762
CAPACITY:
49
CENSUS:
8
DATE:
02/10/2020
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
04:07 PM
MET WITH:
Young Barbara
TIME COMPLETED:
04:40 PM
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Licensing Program Analyst (LPA) Nelson Zuniga conducted a visit to the facility to provide a amended copy of report dated 01/28/2020.
An exit interview was conducted.
SUPERVISOR'S NAME:
Gilbert Sena
TELEPHONE:
(951) 782-4844
LICENSING EVALUATOR NAME:
Nelson Zuniga
TELEPHONE:
(951) 782-6634
LICENSING EVALUATOR SIGNATURE:
DATE:
02/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/10/2020
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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