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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364803359
Report Date: 11/06/2024
Date Signed: 11/06/2024 08:51:15 AM

Document Has Been Signed on 11/06/2024 08:51 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:MARCY FAMILY CHILD CAREFACILITY NUMBER:
364803359
ADMINISTRATOR/
DIRECTOR:		LISA MARCYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 428-1150
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
11/06/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Lisa MarcyTIME VISIT/
INSPECTION COMPLETED:
09:00 AM
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On date and time listed above, Licensing Program Analyst (LPA) Aman Lama conducted a case management visit to deliver an amended report from 10/02/24. LPA was granted access into the facility by licensee, Lisa Marcy. LPA then toured the facility and took census.

No deficiencies cited during todays visit.

Report was reviewed and exit interview was conducted with licensee, Lisa Marcy.

Notice of site visit was issued and must remain posted for 30 consecutive days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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