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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330910496
Report Date: 04/15/2026
Date Signed: 04/15/2026 11:09:00 AM

Document Has Been Signed on 04/15/2026 11:09 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:SAN JACINTO PRESCHOOLFACILITY NUMBER:
330910496
ADMINISTRATOR/
DIRECTOR:		ZARAGOZA, ELIZABETHFACILITY TYPE:
850
ADDRESS:257 GRAND ARMYTELEPHONE:
(951) 654-1531
CITY:SAN JACINTOSTATE: CAZIP CODE:
92583
CAPACITY: 82TOTAL ENROLLED CHILDREN: 82CENSUS: 68DATE:
04/15/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:55 AM
MET WITH:Director Elizabeth ZaragozaTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
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On 04/15/2026, Licensing Program Analyst (LPA) Brian Morris conducted an unannounced Case Management inspection to follow-up on an Unusual Incident Report (UIR) submitted to Community Care Licensing on 03/26/2026. LPA met with Director Elizabeth Zaragoza and toured the facility and gathered census. During this visit, LPA collected pertinent documents, interviewed staff members who witnessed the incident and had direct knowledge of what occurred.

Per incident report, on March 26, 2026, teacher Ms. Ingrid notified the parent of C1, to inform the mother that C1 had a bruise on their left leg and was limping. Ms. Ingrid shared with the mother that C1 reported they were hurt at home when they stepped on the rock. The mother replied via Class Dojo to Ms. Ingrid to notify San Jacinto Preschool that C1 did not get hurt at her house. The mother met with Director Elizabeth and asked her to view the facility outside cameras. Director Elizabeth independently reviewed the camera footage and observed C1 fall and hurt their leg during outside play.

An office staff member informed Director Elizabeth that the mother was on site and would like to meet with Director Elizabeth. The director spoke with Perla at Community Care Licensing to inform her of the incident. Director Elizabeth also informed the coordinator at RCOE.

Confidential interviews revealed that Ms. Ingrid was present during the Outside time at San Jacinto Preschool on 03/26/2026 prior to 11:00 AM when outside time starts. Ms. Ingrid reports, the left shin area for C1 was already bruised when they arrived on 03/26/2026, so we thought the mother was aware of the injury, which is why I wrote her the message on Class Dojo, C1 was at their father’s house, and the mother was not aware of the situation. Ms. Ingrid notified Director Elizabeth of the incident and observed C1 and provided treatment. Ms. Ingrid reports, C1, reported the injury that happened during outside time and pointed to the playground area, when asked where they hurt their left leg.

NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: SAN JACINTO PRESCHOOL
FACILITY NUMBER: 330910496
VISIT DATE: 04/15/2026
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Director Elizabeth reviewed camera footage from the date in question and believes C1 did accidentally slip on the playground area but resumed playing before contacting Ms. Ingrid on 03/26/2026. Director Elizabeth reports, staff responded appropriately and treated C1 who went back to playing without incident within minutes per Director Elizabeth and Ms. Ingrid. Director Elizabeth and Ms. Ingrid deny any additional concerns. Director Elizabeth reports, C1 was disenrolled on 03/30/2026.

C1's mother was contacted and responded to pick up C1. In addition, the incident was reported to CCL and documentation observed in the injured child’s file. Records review also confirmed that the CCC was operating within proper staff to child ratios. Additionally, LPA observed the playground and area of incident and found no Title 22 violations that would have contributed to C1's injury.

No Deficiencies issued.

An exit interview was held with Director Elizabeth Zaragoza. A copy of this report was issued, along with a Notice of Site visit. This report shall be public record for three years.

NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC809 (FAS) - (06/04)
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