<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845525
Report Date: 01/29/2025
Date Signed: 01/29/2025 12:03:14 PM

Document Has Been Signed on 01/29/2025 12:03 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:MAHMOOD FAMILY CHILD CAREFACILITY NUMBER:
334845525
ADMINISTRATOR/
DIRECTOR:		MAHMOOD, LUBNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 550-6115
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
01/29/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:37 AM
MET WITH:Lubna Mahmood, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On Wednesday, January 29, 2025, Licensing Program Analysts (LPAs) Jesse Gardner and Hayley McCarthy arrived unannounced to deliver an amended report dated 05/23/2024.

An exit interview was held with Lubna Mahmood. A copy of this report was issued, along with a Notice of Site visit. This report shall be public record for three years.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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 1