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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842605
Report Date: 05/31/2022
Date Signed: 05/31/2022 01:07:23 PM

Document Has Been Signed on 05/31/2022 01:07 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:SANTOS FAMILY CHILD CAREFACILITY NUMBER:
334842605
ADMINISTRATOR:SANTOS, VERONICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 208-4273
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:39 AM
MET WITH:Veronica Santos TIME COMPLETED:
01:10 PM
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On May 31, 2022 at 11:39 AM, Licensing Program Analyst (LPA) Anastasia Flores arrived unannounced to conduct a mandatory compliance review of facility. LPA conducted a safety inspection of the FCC, informed Licensee of the purpose of the visit and was asked if there could be a LPA that speaks Spanish available for the tour. LPA communicated with the licensee through 20 year old daughter that a Spanish LPA will be requested.

LPA observed a lock and door lock on the pool fence, advised the licensee the pool regulations.

A notice of site visit, copy of this report, LIC811(Confidential Names) and appeal rights were provided to licensee on 05/31/22.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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