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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364818329
Report Date: 03/14/2023
Date Signed: 03/14/2023 01:04:36 PM

Document Has Been Signed on 03/14/2023 01:04 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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:RIOS FAMILY CHILD CAREFACILITY NUMBER:
364818329
ADMINISTRATOR:RIOS, MARTHA HOPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 217-1445
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Martha RiosTIME COMPLETED:
01:30 PM
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On 03/14/2023, Licensing Program Analyst (LPA) Aman Sharma arrived at the facility on a different matter. During the tour, LPA noticed a room behind the kitchen/dining room area. The room did not exist during the pre licensing inspection on 11/13/2006.

Based on observation and licensee's own admission, the room is on-limits and used by daycare children. The licensee was unable to provide a permit from the city for this room. Licensee plans to keep this room off-limits to daycare children. Licensee locked the door, putting it off-limits to the daycare children during this inspection. The facility is in compliance with Title 22 Regulations at this time. -SEE LIC809D.

An exit interview was conducted with Licensee, Martha Rios and appeal rights were provided. A Notice of Site visit was issued, along with a copy of this report. This report shall be public record for three years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2023
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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Document Has Been Signed on 03/14/2023 01:04 PM - It Cannot Be Edited


Created By: Aman Sharma On 03/14/2023 at 12:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RIOS FAMILY CHILD CARE
FACILITY NUMBER: 364818329

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/15/2023
Section Cited
CCR
102416.3(a)(2)

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Alterations to Existing Buildings or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:(2) Room additions to the family child care home.
This requirement was not met as evidenced by:
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Licensee plans to keep the room off-limits to the daycare children. Licensee locked the door to ensure it is off-limits to the daycare children. Licensee will submit a new LIC999 Facility Sketch (Floor Plan), showing the room addition.
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A room behind the kitchen and dining room was observed to be available to daycare children. Licensing was never informed of the installation of this room. There is no permit for the city for this room either.
This poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kimberly Williams
LICENSING EVALUATOR NAME:Aman Sharma
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2023


LIC809 (FAS) - (06/04)
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