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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843752
Report Date: 02/10/2025
Date Signed: 02/10/2025 02:01:58 PM

Document Has Been Signed on 02/10/2025 02:01 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 SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CANCINO FAMILY CHILD CAREFACILITY NUMBER:
334843752
ADMINISTRATOR/
DIRECTOR:		MICHELLE CANCINOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 319-6325
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/10/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Marco CancinoTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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
On 02/10/25, Licensing Program Analyst (LPA), Kelli Waters, conducted an unannounced Case Management visit to follow up on unpaid licensing fees. The facility was closed for the day due to illness however LPA was able to meet with spouse of Licensee. LPA Waters delivered the Overdue Fees letter as well as PIN number required for payment.

Spouse verified that facility is still active and payment will be made.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2025
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