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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845821
Report Date: 02/16/2023
Date Signed: 02/16/2023 02:58:18 PM

Document Has Been Signed on 02/16/2023 02:58 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 SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ORTIZ FAMILY CHILD CAREFACILITY NUMBER:
334845821
ADMINISTRATOR:ORTIZ,ELIZABETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 391-7110
CITY:MECCASTATE: CAZIP CODE:
92254
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
02/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Elizabeth OrtizTIME COMPLETED:
03:10 PM
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On February 16, 2023 at 2:10 pm, Licensing Program Analyst (LPA) Ana Noble arrived at the facility to conduct a case management visit. LPA met with Elizabeth Ortiz, Licensee and toured entire the home. Present during this inspection was 9 day-care children and Edward Ortiz, Licensee's spouse. The licensee's minor children who live in the home were not present during this visit. LPA interviewed Licensee and obtained information regarding individuals who would present during normal day-care hours.

LPA observed no deficiencies during this inspection.

An exit interview was conducted, and this report was reviewed with the licensee, Elizabeth Ortiz. Appeal rights were discussed and provided during the exit interview. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2023
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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