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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841081
Report Date: 11/04/2021
Date Signed: 11/04/2021 11:50:09 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:ABUNDANT PRESCHOOL OF LEARNINGFACILITY NUMBER:
364841081
ADMINISTRATOR:DOMINIGUE LUCIENFACILITY TYPE:
850
ADDRESS:10900 CIVIC CENTER DRIVETELEPHONE:
(909) 204-4514
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:128CENSUS: 94DATE:
11/04/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:04 AM
MET WITH:Dominique Lucien/DirectorTIME COMPLETED:
12:05 PM
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On 11/4/21 at 11:00 am, Licensing Program Analyst (LPA) Patricia Berry conducted a case management visit to conducted additional interviews with staff and collect documentation relating to the complaint investigation from 9/24/21. LPA Berry interviewed three staff, and parent handbook.



Exit interview conducted with director report and appeal rights given.

LPA observed director post notice of site visit.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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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