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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376623979
Report Date: 10/15/2019
Date Signed: 10/15/2019 03:42:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:RIVERO, MACLOVIA & MAGANA, EDUARDO FCCFACILITY NUMBER:
376623979
ADMINISTRATOR:RIVERO, MACLOVIA & EDUARDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 920-4860
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY:14CENSUS: 0DATE:
10/15/2019
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Maclovia RiveroTIME COMPLETED:
03:50 PM
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Regional Manager (RM) Shelley High, Licensing Program Managers (LPMs) Tulam Vu and Joe Carrasco, Licensing Program Analysts (LPAs) Yolanda Baez, Gloria Gonzalez, and Dana Stevens met with Licensee, Maclovia Rivero for a Non-Compliance Conference at the San Diego Child Care Regional Office (SDCCRO) on this date.

The LIC9111 was signed and provided to Licensee, Maclovia Rivero. In addition, Licensee provided proof of immunity against Measles for herself during today's office meeting and a POC letter was provided to Licensee to show proof of clearing the Type B deficiency for Health and Safety Code section 1596.622(a)(1).

This case will be referred to legal for further review.

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
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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