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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840766
Report Date: 11/08/2023
Date Signed: 11/08/2023 01:20:10 PM

Document Has Been Signed on 11/08/2023 01:20 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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:SCHOOL TIME MONTESSORIFACILITY NUMBER:
334840766
ADMINISTRATOR:MONICA G. MACIELFACILITY TYPE:
850
ADDRESS:10235 WELLS DRIVETELEPHONE:
(951) 689-1151
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY: 89TOTAL ENROLLED CHILDREN: 89CENSUS: 27DATE:
11/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Monica Maciel TIME COMPLETED:
01:25 PM
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On the date and time listed above, Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to conduct an investigation in regard to a complaint received. During arrival it was discovered complaint information was on wrong facility. LPA was given access to the facility by Monica Maciel. LPA discussed purpose of visit, took census and discussed other facility. LPA concluded visit.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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