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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840687
Report Date: 01/22/2024
Date Signed: 01/22/2024 12:02:09 PM

Document Has Been Signed on 01/22/2024 12:02 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:MALDONADO FAMILY CHILD CAREFACILITY NUMBER:
334840687
ADMINISTRATOR:MALDONADO, DOLORESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 432-7533
CITY:CORONASTATE: CAZIP CODE:
92880
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
01/22/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:29 AM
MET WITH:Licensee DOLORES MALDONADOTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Steven Montoya met licensee Dolores Maldonado for the purpose of Case Management follow up. LPA disclosed the purpose of follow up inspection was to review children's files and inspect backyard fencing and pool fencing.

Present during today’s inspection were 7 children in care and ratios were within title 22 guidelines, LPA toured of the child care home, review files and no deficiencies were observed.

Based on observation no further follow up is required. A copy of the inspection report and notice of site visit was provided to Director.

Exit
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Steven Montoya
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2024
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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