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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830639
Report Date: 08/31/2023
Date Signed: 08/31/2023 08:12:22 AM

Document Has Been Signed on 08/31/2023 08:12 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KIDD STREET PRESCHOOL OF RIVERSIDEFACILITY NUMBER:
334830639
ADMINISTRATOR:MARIA TEELFACILITY TYPE:
850
ADDRESS:10250 KIDD STREETTELEPHONE:
(951) 688-4242
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY: 155TOTAL ENROLLED CHILDREN: 155CENSUS: 38DATE:
08/31/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Lucia CasillasTIME COMPLETED:
08:20 AM
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On the date and time listed above, a case management visit was conducted by Licensing Program Analyst (LPA) Giselle Carbullido to deliver an amended report. During today’s visit, LPA toured the facility and census was taken, with 38 children present. LPA met with Lucia Casillas, Director to deliver amended report.

Exit interview conducted and a copy of this report and notice of site visit was provided to the Licensee. A copy of this report must be made available to the public for 3 years.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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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