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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364810041
Report Date: 02/28/2024
Date Signed: 02/28/2024 10:26:08 AM

Document Has Been Signed on 02/28/2024 10:26 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:SBCUSD-WARM SPRINGS PRESCHOOLFACILITY NUMBER:
364810041
ADMINISTRATOR:KELLY, LATASHIAFACILITY TYPE:
850
ADDRESS:7497 STERLING AVENUETELEPHONE:
(909) 338-6500
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92410
CAPACITY: 23TOTAL ENROLLED CHILDREN: 23CENSUS: 21DATE:
02/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:17 AM
MET WITH:Teacher Assistant Lupe Cervantez TIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Steven Montoya arrived and met Assistant Teacher (S2) for the purpose of following up on Unusual Incident Report (UIR) investigation at SBCUSD Warm Springs dated 2-23-2024 regarding allegation of child injury and personal rights violation.

LPA disclosed the purpose of the inspection. Present during today’s inspection were 21 children in care and staff. LPA completed a tour of the facility and interview relevant witnesses and no deficiencies were observed.

Based on the information obtain, further investigation is required in order to resolve the complaint. A copy of the inspection report, appeals rights and notice of site visit was provided to the Teacher Assistant.

Exit
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Steven Montoya
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2024
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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