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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330920921
Report Date: 05/31/2024
Date Signed: 05/31/2024 10:39:18 AM

Document Has Been Signed on 05/31/2024 10:39 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:RCOE - ARLANZA HEAD STARTFACILITY NUMBER:
330920921
ADMINISTRATOR/
DIRECTOR:		MONICA PARGAFACILITY TYPE:
850
ADDRESS:5891 RUTLAND AVENUETELEPHONE:
(951) 352-7984
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 0DATE:
05/31/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Yvonne BaileyTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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A case management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 05/29/2024.
Facility staff were interviewed and records were reviewed and obtained. Further information will be needed. Upon completion of the review, the outcome and/or recommendations will be provided to the licensee.
An exit interview was conducted and a copy of this report was provided to facility staff Yvonne Bailey.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2024
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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