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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845360
Report Date: 06/26/2024
Date Signed: 06/26/2024 10:52:29 AM

Document Has Been Signed on 06/26/2024 10:52 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:MUSTAFFA FAMILY CHILD CAREFACILITY NUMBER:
334845360
ADMINISTRATOR/
DIRECTOR:		MUSTAFFA, KATHI-JOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 813-0750
CITY:SAN JACINTOSTATE: CAZIP CODE:
92582
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
06/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:59 AM
MET WITH:Kathi-Jo MustaffaTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On June 26, 2024, at 9:05 am, Licensing Program Analyst (LPA) Cindy Hamilton arrived at the facility to conduct a Case Management inspection due to a recent installation/addition of a swimming pool. LPA Hamilton met with the Licensee Kathi-Jo Mustaffa and informed her of the purpose of the visit.

As early as 3/12/24, the Licensee informed Community Care Licensing (CCL) via the duty line of a pool to be installed at the home/facility. During the call licensee was advised fencing requirements for the pool. On 3/16/24, LPA Hamilton spoke with licensee who advised pool construction would begin 4/22/24 and pool would be completed about mid July. Licensee stated backyard would be off-limits to daycare children until pool is completed. On 6/21/24, LPA Hamilton received another email from licensee, along with video showing the completion of the pool.

During today's visit, LPA Hamilton toured the facility, inside and out. LPA inspected the backyard, inspecting the pool and the fence that surrounds it. The pool is fenced with 5 foot wrought iron fencing surrounding the entire pool and has self latching/closing door. The backyard is fenced with 5ft vinyl fencing around all sides of the home. In addition, licensee has installed alarm on the windows and sliding glass door that leads out to patio area between the home and the pool, with the separate wrought iron fencing around the pool. Licensee has also purchased a Pool Guard in pool alarm that detects movement inside pool water that is o be installed. LPA received a copy of the facility sketch during the inspection for filing. The pool fencing meets Title 22 regulations at this time.

An exit interview was conducted, a copy of this report, appeal rights and notice of site visit was provided to licensee. Licensee was reminded that the notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
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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