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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846320
Report Date: 02/03/2023
Date Signed: 02/03/2023 03:30:00 PM

Document Has Been Signed on 02/03/2023 03:30 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:HERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
334846320
ADMINISTRATOR:HERNANDEZ,JAZMINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 660-5268
CITY:RIVERSIDESTATE: CAZIP CODE:
92505
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/03/2023
TYPE OF VISIT:Case Management - Infrastructure GrantUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Jazmin HernandezTIME COMPLETED:
03:50 PM
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On 2/3/23 at 2:45 PM Licensing Program Analysts, Claudia Caywood and Patricia Berry conducted a case management in regards to a infrastructure grant. LPA's met with Jamzin Hernandez, LPA's were granted access in to the facility, toured facility, and took a census. LPA's observed no children present during the inspection.

LPA's observed a gate with a lock on it, which separates the parking lot from the day care play ground. LPA's observed the parking lot is inaccessible to the children in care. LPA's observed a sealant on the asphalt, which licensee stated she added in order to prevent potential slipping hazards.

Exit interview conducted with Jazmin Hernandez. The report, appeal rights, and a notice of site visit issued. The notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2023
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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