<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841081
Report Date: 09/15/2020
Date Signed: 09/15/2020 11:14:43 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: 65DATE:
09/15/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Dominque Lucien/DirectorTIME COMPLETED:
11:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 9/15/2020 at 10:00 AM, Licensing Program Analyst (LPA) Patricia Berry conducted an unannounced case management tele-visit due to COVID-19 and social distancing, to follow up on a Confirmation of Removal for Billy Duenas, which was issued on 9/10/2020. LPA met with Dominique Lucien, Director. LPA toured facility and took census and verified teachers’ names working during visit.

LPA explained the written Confirmation of Removal for Duenas. Director stated, Duenas, has never worked at the facility. Director stated, Duenas was live scanned to be a student at the Church College. Director stated, Duenas has never or in the future has any reason to be in or around the preschool.


Based on evidence obtained during todays' tele-visit, the LPA has verified the individual is not present, employed or residing in the facility. LPA has advised the licensee to update facility roster if needed.


An exit interview was conducted with director and a notice of site visit issued.


Verification of removal is complete.

This report will be sent via email to the provided email address with an attached read receipt. A copy of the LIC 9213 will be sent via email along with the report. The read receipt will be used in lieu of the signature on the report.


LIC 9213 must be posted at teh entrance of the facility for 30 days.
All reports shall be maintained for three years.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1