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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844040
Report Date: 07/14/2022
Date Signed: 07/14/2022 03:55:07 PM


Document Has Been Signed on 07/14/2022 03:55 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:MEZA FAMILY CHILD CAREFACILITY NUMBER:
364844040
ADMINISTRATOR:REBECCA MEZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 377-5227
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY:14CENSUS: 15DATE:
07/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Rebecca MezaTIME COMPLETED:
04:15 PM
NARRATIVE
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On the date and time listed, Licensing Program Analysts (LPAs) Kay Tuner, Rachel Zeron and Aman Sharma visited the facility for a complaint investigation. While on the visit, LPAs were made aware that the facility had fifteen children in care. Upon arrival, LPAs met with Enrique Gutierrezmeza who explained that the licensee was on her way back from running errands.

LPAs took census, the census at the time of arrival was 13 children and two staff. Staff indicated to LPAs that there were two other children who were out on a field trip with another staff member, which puts the facility over ratio.

The licensee arrived on site approximately 20 minutes after LPAs arrival. Licensee indicated that in addition to the thirteen children in care, two additional older children were on a water park field trip with another staff. LPAs determined the facility was over ratio by one child.


Deficiencies were cited on visit.

See attached LIC-809D.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2022
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MEZA FAMILY CHILD CARE
FACILITY NUMBER: 364844040
VISIT DATE: 07/14/2022
NARRATIVE
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This report cites a Type A violation and shall be provided to parents/guardians of children currently enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file. In addition, a copy of the case management visit (LIC809) shall be posted next to the door and must remain posted for 30 consecutive days. LPAs Turner, Zeron and Sharma provided the Licensee, Rebecca Meza with section 1596.8595 instructions from the Health and Safety code related to Type A violations. LPAs Turner, Zeron and Sharma also provided a printout of LIC9224.

Exit interview was conducted with the Licensee, Rebecca Meza. Notice of Site Visit was posted during the visit. The Licensee was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal Rights and deficiency was discussed. The Licensee, Rebecca Meza was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 07/14/2022 03:55 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501


FACILITY NAME: MEZA FAMILY CHILD CARE
FACILITY NUMBER: 364844040

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/15/2022
Section Cited

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Staffing Ratio and Capacity: (f) The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.

This requirement was not met as evidenced by:
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Licensee indicated that she did have two additional older chidlren on a field trip to a water park with another staff member.
LPA's determined this put the facilities ratio at 15 children, which puts the facilities ratio over due to one child.
This poses an immediate risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman SharmaTELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3