<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842174
Report Date: 04/27/2023
Date Signed: 04/27/2023 09:52:16 AM

Document Has Been Signed on 04/27/2023 09:52 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:VEA FAMILY CHILD CAREFACILITY NUMBER:
334842174
ADMINISTRATOR:VEA, ZAIRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 443-4184
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
04/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:56 AM
MET WITH:Zaira VeaTIME COMPLETED:
10:05 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Ana Noble arrived at the facility on a case management inspection to follow-up on an Unusual Incident Report (UIR) which occurred on March 9, 2023 per Licensee. LPA met with Zaira Vea, Licensee and provided purpose of inspection. At the time of inspection, LPA toured the facility, took census, interviewed and reviewed documents previously submitted to the department with Zaira Vea, Licensee.
The reported incident took place on March 9, 2023, regarding a child that was bitten by Licensee's dog.

LPA interviewed Licensee and attempted to make contact with Child #1 (C1), Parent which was unsuccessful. LPA also reviewed C1 file. LPA will extend the investigation to obtain additional information.

An exit interview was conducted with Zaira Vea, Licensee and a copy of this report was provided along with appeal rights and Notice of Site visit. Notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1