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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300130
Report Date: 05/02/2023
Date Signed: 05/02/2023 10:56:19 AM

Document Has Been Signed on 05/02/2023 10:56 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:RODRIGUEZ FAMILY CHILD CAREFACILITY NUMBER:
336300130
ADMINISTRATOR:RODRIGUEZ,MARILYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 828-1268
CITY:TEMECULASTATE: CAZIP CODE:
92592
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
05/02/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Marilyn RodriguezTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA), William Chancellor conducted a case management visit to deliver an amended report regarding a citation that was given in error on the annual inspection completed on April 26, 2023. The report was reviewed with and provided to Licensee Marilyn Rodriguez. Nothing further is needed at this time. An exit interview was conducted, and a copy of this report and a Notice of Site Visit was provided to Licensee Marilyn Rodriguez.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2023
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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