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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334818148
Report Date: 01/10/2023
Date Signed: 01/10/2023 09:20:22 PM

Document Has Been Signed on 01/10/2023 09:20 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ESPINO FAMILY CHILD CAREFACILITY NUMBER:
334818148
ADMINISTRATOR:LAURA ESPINOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 449-0413
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/10/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:51 PM
MET WITH:TIME COMPLETED:
01:59 PM
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On January 10, 2023 at 1:55 PM, Licensing Program Manager (LPM) Pauline Beschorner, Licensing Program Analyst's (LPA's) Anastasia Flores and Courtnee Peebles arrived to conduct a case management visit in regard to the inactive status of facility. LPA knocked on the door and rang the doorbell of the facility with no response. There was not evidence of children to be heard or seen.

LPA Flores left a business card on the door, the telephone number for licensee is disconnected

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2023
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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