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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300700
Report Date: 08/16/2023
Date Signed: 08/16/2023 01:20:41 PM

Document Has Been Signed on 08/16/2023 01:20 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:JENKINS FAMILY CHILD CAREFACILITY NUMBER:
336300700
ADMINISTRATOR:JENKINS,VAINOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 795-3010
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
08/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Vaino JenkinsTIME COMPLETED:
01:30 PM
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On August 16, 2023 at 12:40 pm, Licensing Program Analyst (LPA) Jessica Rubio arrived unannounced to Jenkins Family Child Care to conduct a case management visit to determine the residents and staff of the facility. LPA conducted a tour and census of the facility. LPA observed twelve children in care with licensee and an assistant (S1) providing care and supervision. LPA interviewed licensee and S1. There were no deficiencies cited at this time.

An exit interview was conducted and this report was reviewed with licensee Vaino Jenkins. Due to printer issues, this report, appeal rights and a notice of site visit were emailed to licensee Vaino Jenkins. The notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Jessica M Rubio
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2023
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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