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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364802729
Report Date: 07/08/2025
Date Signed: 07/08/2025 02:17:45 PM

Document Has Been Signed on 07/08/2025 02:17 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:GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
364802729
ADMINISTRATOR/
DIRECTOR:		GUZMAN, GUADALUPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 982-5857
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/08/2025
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:59 PM
MET WITH:Guadalupe GuzmanTIME VISIT/
INSPECTION COMPLETED:
02:19 PM
NARRATIVE
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On 07/08/2025 an Informal Conference was held at the Riverside Regional Office. Present in the conference were Licensee Guadalupe Guzman; Licensing Program Manager (LPM) Ana Noble and Licensing Program Analyst (LPA) Chase Atherton.

The Purpose of the meeting was to review and discuss the following:

· Operation of Family Child Care Home - Current control of property.
· Personal Rights
· Alterations to Existing Buildings and Grounds
· Fire Clearance
· Pending POCs

Licensee was advised to visit the Department's website at:
https://cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensing related information to licensed facilities, visit the CCLD Important Information website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Childcare option to receive email communication.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Chase Atherton
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 364802729
VISIT DATE: 07/08/2025
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- Technical Support Program (TSP) was discussed with the licensee and was encouraged to voluntarily enroll or seek training from an outside vendor in the areas discussed during this informal conference. The Licensee was provided with the following: TSP Brochure, TSP Information Page, 102371 Fire Safety Clearance.
- Licensee Guadalupe Guzman, was also encouraged to contact Resources and Referrals Agency (800-822-577 or 909-387-4740 ext25030) for additional resources and training pertaining to Operating a Family Child Care Home.

- A link to videos for Family Child Care Providers – California Child Care Licensing – Resources for Parents and Providers can be found on the Community Care Licensing Website – Family Child Care Home, which can be accessed at https://ccld.childcarevideos.org/family-child-care-providers/



As a result of this informal conference, Licensee Guadalupe Guzman understands the department’s expectations regarding the 102417 Operation of a Family Child Care Home, 102423 Personal Rights, 102416.3 Alterations to Existing Buildings or Grounds, and 102371 Fire Safety Clearance. The Licensee also understands that not remaining in compliance can lead to additional administrative actions.

A Plan of Correction Visit will be completed to verify this information and to clear outstanding Plan of Corrections (POCs). Licensee Guadalupe Guzman provided a picture that shows that all child care items have been removed from the garage and a fence has been placed to section off a majority of the garage.

Licensee understands that the garage is not to be used for daily use as child care room, eating and sleeping is prohibited.

The licensee agrees to submit an updated proof of control of property (rental or lease agreement) and the updated facility sketch on or before 07/15/2025.

LPA Chase Atherton informed Licensee to provide a copy of this licensing report dated 07/08/2025 to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care and to any newly enrolled children's parents/guardians for the next 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Chase Atherton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025
LIC809 (FAS) - (06/04)
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