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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844722
Report Date: 05/17/2024
Date Signed: 05/17/2024 08:50:18 AM

Document Has Been Signed on 05/17/2024 08:50 AM - 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:VALLE VISTA ANNEX PRESCHOOLFACILITY NUMBER:
334844722
ADMINISTRATOR/
DIRECTOR:		MELINA SERNAFACILITY TYPE:
850
ADDRESS:26205 FAIRVIEW AVE.TELEPHONE:
(951) 765-1648
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY: 116TOTAL ENROLLED CHILDREN: 116CENSUS: 11DATE:
05/17/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:03 AM
MET WITH:Elise SalazarTIME VISIT/
INSPECTION COMPLETED:
08:45 AM
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On May 17, 2023, at 8:03 AM, Licensing Program Analyst (LPA) Anastasia Flores, arrived and was granted access to the facility by, Teacher, Christine Jiron. LPA informed Ms. Jiron, the purpose of the visit was for an incident report filed in our office on 05/01/24. Incident involved a child having been scratched or bitten by a gopher on the playground on 04/30/24. LPA toured the playground, took photo of the area the incident occurred and conducted interview with teacher.

LPA discussed the safety of the playground and efforts that were made to prevent this from happening in the future. LPA was informed that the Director of maintenance was immediately notified, and came over to try to locate the gopher, without success. LPA was informed Maintenance has been conducting maintenance to prevent gophers from coming into the yard. There are no deficiencies at this time.

An exit interview, a copy of report and appeal rights were handed to teacher Elise Salazar.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2024
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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