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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846161
Report Date: 01/27/2025
Date Signed: 01/27/2025 12:00:54 PM

Document Has Been Signed on 01/27/2025 12:00 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KIDDIE ACADEMY OF CORONAFACILITY NUMBER:
334846161
ADMINISTRATOR/
DIRECTOR:		MELISSA BORBOAFACILITY TYPE:
850
ADDRESS:3977 BEDFORD CANYON ROADTELEPHONE:
(951) 444-7434
CITY:CORONASTATE: CAZIP CODE:
92883
CAPACITY: 108TOTAL ENROLLED CHILDREN: 108CENSUS: 94DATE:
01/27/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:23 AM
MET WITH:Melissa Borboa, DirectorTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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A case management visit was conducted on 1/27/2025 at 11:20 AM in response to the receipt of a self reported unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 1/17/2025. It was reported that on 1/10/2025 a child was playing on the playground and the child tripped and cut their head on a play stage causing a cut on their head.

Licensing Program Analyst (LPA) observed the play stage area where the child fell and interviewed staff. Based on the information gathered, the facility acted appropriately, and no violations have been identified. Facility staff immediately contacted the child’s guardians and the child was immediately taken to receive medical attention. The licensee notified the department about the incident on an unusual incident report (UIR) The incident was reported in a timely manner and corrective protocols were taken by facility staff.

An exit interview was conducted, and report was reviewed with the Site Director, Melissa Borboa. A Notice of Site Visit was issued and is to be posted in a prominent location at the facility for the next 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2025
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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