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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334818307
Report Date: 02/12/2025
Date Signed: 02/12/2025 03:06:42 PM

Document Has Been Signed on 02/12/2025 03:06 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
334818307
ADMINISTRATOR/
DIRECTOR:		CONSUELO GUZMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 972-8964
CITY:COACHELLASTATE: CAZIP CODE:
92236
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
02/12/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Consuelo GuzmanTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 02/12/2025, while Licensing Program Analyst (LPA ) Gabriela Hernandez was conducting annual inspection, LPA followed up on an unusual incident report received on 01/24/2025.

LPA interviewed Licensee Consuelo Guzman in regards to the incident. Per licensee, on 01/24/2025, they were doing a music and movement activity inside the play room. Licensee stated C1 jumped, turned, and crouched Licensee stated as C1 was crouching down they hit their forehead on a wooden activity table that was nearby. Licensee stated C1 sustained a small cut on their forehead. Licensee stated they applied pressure and cleaned the injury. Per Licensee, they contacted mom to pick up C1, mother responded and took C1 to the doctors. C1 received stiches. C1 returned to the family child care the following Monday. The incident occurred on a Friday. Licensee stated parents were understanding of the incident and had no concerns.

Based on all the information obtained by LPA's, there does not appear to be any violations of Title 22 Regulations pertaining to the reported incident.

An exit an interview was conducted. A copy of this report and appeal rights were provided at the time visit.

A notice of site visit was given and shall remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Gabriela Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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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