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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817393
Report Date: 05/25/2021
Date Signed: 05/26/2021 08:42:31 AM

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:EASTER SEALS CHILD DEVELOPMENT CENTER-ONTARIOFACILITY NUMBER:
364817393
ADMINISTRATOR:APRYL CABRERAFACILITY TYPE:
850
ADDRESS:2999 S. HAVEN AVETELEPHONE:
(909) 923-3352
CITY:ONTARIOSTATE: CAZIP CODE:
91761
CAPACITY:48CENSUS: 30DATE:
05/25/2021
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Kasandra Torres- DirectiorTIME COMPLETED:
10:45 AM
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Due to COVID-19, Licensing Program Analyst (LPA) Rachel Zeron conducted a Tele-inspection with Director Kasandra Torres. The Case Management follow up Tele-inspection was held to follow up on an unusual incident that occurred on May 14, 2021. LPA Met with the Director via Zoom. Per the Director there were 30 children in care. LPA is investigating a possible lack of supervision allegation that was self reported by the facility on 05/14/2021.

LPA conducted interviews with staff and children, additional interviews are required to complete the investigation, LPA will conduct remaining interviews on a later date.

LPA conducted an exit interview with Director and went over the expectations of the facility during COVID -19. LPA emailed a copy of the report and Notice of Site Visit to the Director, instructed the Director to sign the report and email it back to the LPA. Director was advised to print the signed copy of this report for record of the visit. Notice of Site visit Is required to be posted for 30 days.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Rachel ZeronTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021
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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