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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844529
Report Date: 07/07/2025
Date Signed: 07/07/2025 12:56:18 PM

Document Has Been Signed on 07/07/2025 12:56 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:MOORE FAMILY CHILD CAREFACILITY NUMBER:
334844529
ADMINISTRATOR/
DIRECTOR:		MOORE JULIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 489-6025
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 14TOTAL ENROLLED CHILDREN: 15CENSUS: 9DATE:
07/07/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:05 AM
MET WITH:Licensee Julie Ann MooreTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
NARRATIVE
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On July 7, 2025, at 11:05 AM, Licensing Program Analyst (LPA) Brian Morris arrived at Moore FCCH #334844529 to conduct a Case Management visit. A Case Management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the Moore FCCH facility #334844529. The UIR was received on 06/20/2025. LPA Morris met with Licensee Julie Ann Moore, and licensee Moore was advised of the reason for the visit. UIR indicated on 06/20/2025, at approximately 12:21 PM, a child’s shoulder was injured. The children were in the daycare area playing, C1 and C2 are siblings and are new to Moore FCCH facility. C1 and C2 were rough housing and playfighting and jumping on each other’s back areas while playing, C1 jumped onto the back of C2 without notice and C1 was unable to keep their balance and fell backwards off of C2s back, injuring C1s right shoulder area. Licensee Moore reports, S1 was present in the facility and working with me and the children, S1 reports, I was supervising the children, and we have been asking them not to rough house and to play nice, they are new to the childcare and still learning the rules here at the facility. S1 reports, the children were rough housing when C1s shoulder was injured, after C1 jumped on C2s back while horseplaying. S1 reports, Licensee Moore and S1 responded to the children and provided first aid care. Licensee Moore reports, I texted G1 immediately to notify them of the incident, G1 responded and picked up C1 and C2 by 12:39PM on 06/20/2025. Licensee Moore reports, staff consoled C1 and C2 who were visibly shaken up by the incident, per licensee Moore. Licensee Moore reports, C1 was diagnosed with a right shoulder fracture, per G1, I have text messages confirming the conversation. Licensee Moore reports, requesting and receiving a medical clearance for C1 to return to childcare 4 days (06/24/2025) with modifications to their play time, no physical activities until further notice.
NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MOORE FAMILY CHILD CARE
FACILITY NUMBER: 334844529
VISIT DATE: 07/07/2025
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During the visit LPA reviewed documents and conducted interviews. LPA confirmed Moore FCCH was in compliance with supervision, ratios, and response time of the incident. In addition, based on the information gathered, Moore FCCH acted appropriately, and no violations of regulations have been identified.

An exit interview was conducted with Licensee Julie Ann Moore. A copy of this report, appeals rights, and a Notice of Site visit were provided to Licensee Moore. This reports shall be public for three years and licensee Moore was reminded that the notice of site visit must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2025
LIC809 (FAS) - (06/04)
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