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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845170
Report Date: 03/27/2023
Date Signed: 03/27/2023 10:31:54 AM

Document Has Been Signed on 03/27/2023 10:31 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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:RANGEL FAMILY CHILD CAREFACILITY NUMBER:
334845170
ADMINISTRATOR:RANGEL, AHURELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 336-5259
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/27/2023
TYPE OF VISIT:Case Management - DeficienciesANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Licensee Ahurelia RangelTIME COMPLETED:
10:45 AM
NARRATIVE
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On 3/27/2023, Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to address a separate and unrelated issue. LPA Lopez had obtained information that the facility closed from 2/14/2023 through 2/23/2023 due to positive COVID-19 cases. This information was never reported to the Riverside Child Care Regional Office.

See LIC809-D for cited deficiency.



A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Ahurelia Rangel.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/27/2023
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 2
Document Has Been Signed on 03/27/2023 10:31 AM - It Cannot Be Edited


Created By: Samuel Lopez On 03/27/2023 at 09:28 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RANGEL FAMILY CHILD CARE
FACILITY NUMBER: 334845170

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2023
Section Cited
CCR
102416.2(c)(3)

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Reporting Requirements - In addition to the events specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C), the licensee shall report the following events to the Department: A communicable disease outbreak when determined by the local health authority.
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Licensee agrees to complete the required Incident Report (LIC 624B) form regarding the closure and the reason for it. Report to be submitted to the Riverside Child Care Regional Office by 3/31/2023.
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This requirement is not being met as evidence by Based on record review, the licensee did not comply with the section cited above. Licensee did not submit an incident report regarding closure due to COVID-19.
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This poses/posed a potential health, safety or personal rights risk to persons in care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Aaron Ross
LICENSING EVALUATOR NAME:Samuel Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2023


LIC809 (FAS) - (06/04)
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