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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843615
Report Date: 07/26/2024
Date Signed: 07/26/2024 04:19:10 PM

Document Has Been Signed on 07/26/2024 04:19 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 SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:RUBIO FAMILY CHILD CAREFACILITY NUMBER:
334843615
ADMINISTRATOR/
DIRECTOR:		LIDIA RUBIOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 574-4775
CITY:COACHELLASTATE: CAZIP CODE:
92236
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 1DATE:
07/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Lidia RubioTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
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On 07/26/2024, a case management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 07/23/2024. The incident report indicates it was reported by the parent/authorized representative, the Child 1 (C1) suffered an injury to C1’s hip and back.

Facility records were reviewed and LPA Valenzuela interviewed LIC and AST1. Based on information gathered at this time, the facility acted appropriately, and no violations have been identified.

An exit interview was conducted and a copy of this report was provided to Licensee Lidia Rubio.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2024
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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