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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819429
Report Date: 11/18/2022
Date Signed: 11/18/2022 02:34:20 PM


Document Has Been Signed on 11/18/2022 02:34 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:MENIFEE PRESCHOOLFACILITY NUMBER:
334819429
ADMINISTRATOR:DR. IFTHIKA "SHINE" NISSARFACILITY TYPE:
850
ADDRESS:26350 LA PIEDRA ROADTELEPHONE:
(951) 672-6478
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY:90CENSUS: 0DATE:
11/18/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Dr. Shine NissarTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) James Wilkerson arrived at this facility to measure four additional classrooms for a capacity increase. The current capacity is 90 ambulatory children. Facility is requesting an additional 70 children of which 10 can be non-ambulatory children. The request was received in the Riverside South East Regional Office on 10/03/22.

The facility was granted a fire clearance on 11/08/22 for 160 ambulatory and 10 non-ambulatory children for a total of 170 children. Per the fire department (STD 850) the new portable classrooms (#13, #14, #15 & #16) are approved for ambulatory children only with an E Occupancy (Children tthrough 12th grade). The existing building is approved for ambulatory or non-amublatory as an #E or I4 (Institutional Group) Occupancy.

There is ample room for the additional 70 children and the request for a capacity increase to 160 children is granted at this time.

An exit interview was conducted, appeal rights, Notice of Site Visit and a copy of this report will be provided to the facility.
SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: James WilkersonTELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:
DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/18/2022
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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