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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364820224
Report Date: 08/14/2023
Date Signed: 08/14/2023 01:34:59 PM

Document Has Been Signed on 08/14/2023 01:34 PM - It Cannot Be Edited

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:DELGADO FAMILY CHILD CAREFACILITY NUMBER:
364820224
ADMINISTRATOR:ROSA-VIRGIL DELGADOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 732-5387
CITY:ONTARIOSTATE: CAZIP CODE:
91761
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
08/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Rosa DelgadoTIME COMPLETED:
01:45 PM
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On this date and time, Licensing Program Analysts (LPA's) Laura Mejorado and Samuel Lopez arrived at facility to conduct a Case Management visit to follow-up on a Notice to Cease Operation letter which was reviewed over the phone on August 11, 2023. Present during the phone call was Licensee Rosa Delgado, Licensing Program Manager (LPM) Kimberly Williams, LPM Aaron Ross and LPA Laura Mejorado.

During todays inspection LPAs met with Licensee Rosa Delgado, also present was Alma Romero and a child resident of the home. This inspection was conducted in Spanish per licensee's request. LPA took census, toured the facility, inside and out, and reviewed partial records which were located in two black trash bags in the backyard.

LPAs provided Licensee a copy of the Notice to Cease Operation letter that was emailed and mailed to Licensee on August 11, 2023. Licensee acknowledged understanding of the notice and did not have any additional questions at this time. Licensee was advised if they had any questions regarding the Notice to Cease Operation they may contact the office at (951) 782-4200 and ask to speak with management.

Exit interview was conducted and report was reviewed with Licensee, Rosa Delgado. A Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2023
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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