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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844604
Report Date: 11/10/2022
Date Signed: 11/10/2022 01:57:22 PM

Document Has Been Signed on 11/10/2022 01:57 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:CEJA FAMILY CHILD CAREFACILITY NUMBER:
334844604
ADMINISTRATOR:CEJA, JASMINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 848-5001
CITY:COACHELLASTATE: CAZIP CODE:
92236
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
11/10/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:27 PM
MET WITH:Jasmin CejaTIME COMPLETED:
02:07 PM
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Licensing Program Analyst (LPA), Ana Noble arrived to the facility to conduct a Case Management for the purpose of verifying the safety measure implemented for the safety of the children during constructions of a inground pool. LPA met Jasmin Ceja, Licensee. LPA toured the back yard, took pictures and provided technical assistance regarding installation of fencing. LPA advised that no windows or doors should have direct access into the body of water/pool after fencing is installed. LPA also provided Ms. Ceja with Title 22 Regulations for the fencing. Licensee will contact LPA Noble prior to filling the pool with water for inspection of the fencing.

Backyard is off-limit during construction.

An exit interview was conducted and a copy of this report was provided to Ms. Ceja, Licensee on this date.

A copy of this report must be made available to the public for 3 years.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2022
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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