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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844011
Report Date: 08/09/2022
Date Signed: 08/24/2022 01:48:43 PM


Document Has Been Signed on 08/24/2022 01:48 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:VOLUNTEERS OF AMERICA EHS CC PPFACILITY NUMBER:
364844011
ADMINISTRATOR:SAVALA, STEPHANIEFACILITY TYPE:
830
ADDRESS:799 E. RIALTO AVENUETELEPHONE:
(909) 332-6690
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92408
CAPACITY:80CENSUS: 28DATE:
08/09/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Herlinda VelasquezTIME COMPLETED:
10:00 AM
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On this date and time, Licensing Program Analyst (LPA) Laura Mejorado arrived at the facility to conduct a case management inspection. The purpose of todays inspection is to ensure the newly installed playground is in compliance. During this inspection, LPA toured the facility inside and outside, took census, and verified associations.

The playground is separated into three sections with a chain-link fence for infants, toddlers and preschool children. The playgrounds consist of age appropriate play structures with rubber mats underneath to absorb falls. Play structures are anchored to the ground and have shade. During this visit the playground appears to be in compliance with Title 22 Regulations.

Exit interview conducted and report was reviewed with Herlinda Velasquez.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura MejoradoTELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2022
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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