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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845673
Report Date: 09/29/2021
Date Signed: 09/29/2021 11:53:09 AM

Document Has Been Signed on 09/29/2021 11:53 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:HOPE UNLIMITED CHILDREN'S CENTERFACILITY NUMBER:
334845673
ADMINISTRATOR:CYNTHIA GLASSFACILITY TYPE:
850
ADDRESS:1170 W. RAMSEY ST.TELEPHONE:
(909) 453-1866
CITY:BANNINGSTATE: CAZIP CODE:
92220
CAPACITY: 15TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Brenda Gomez, Finance OficerTIME COMPLETED:
12:00 PM
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Licensing Program Analyst, Giselle Carbullido arrived at the facility to conduct an annual inspection. LPA met with Brenda Gomez, Finance Officer. Ms. Gomez informed LPA that the church is not operating the day-care and has been closed since last year due to COVID. The facility has not enrolled children as of this date.

LPA Carbullido informed Ms. Gomez of the option for license to be placed on inactive status. LPA Carbullido provided information regarding inactive status. Ms. Gomez decided to place license on inactive status. LPA provided Ms. Gomez with Request for Inactive Status Form, LIC9211. Ms. Gomez completed Request for Inactive Status form LIC9211 with start date 09/29/21 through 09/29/22.

LPA reminded Ms. Gomez that annual license fees must be paid promptly and before reopening the day-care, Ms. Gomez or facility administrator will contact the Department.

Exit interview was conducted with Ms. Gomez and a copy of this report was provided during this visit.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2021
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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