<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842493
Report Date: 05/10/2023
Date Signed: 05/10/2023 10:20:39 AM

Document Has Been Signed on 05/10/2023 10:20 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:FOSTER FAMILY CHILD CAREFACILITY NUMBER:
364842493
ADMINISTRATOR:FOSTER, LOLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 616-2431
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
05/10/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Lola FosterTIME COMPLETED:
10:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Laura Mejorado and Justin Giese made an unannounced plan of corrections visit for citations issued during an unannounced visit to the facility on 05/03/2023. LPAs met with Licensee Lola Foster who had one blood related child in care and discussed the purpose of the visit.

Licensee was cited on 05/03/2023 for failing to keep the home clean and orderly. Licensee had a cleaning service come out to the home on 05/04/2023. During todays visit LPAs inspected the home and found the home had been cleaned.

Licensee was cited on 05/03/23 for failing to move infants to a crib to finish sleeping. While touring the facility on 05/03/2023 there was a crib in the home which was filled to the top with clothes and other items. During todays visit crib was clean and free of loose articles.

The following is needed to clear the citations issued on 05/03/2023.

Documents needed:
- A written statement addressing how the facility will be maintained clean and orderly
- A written statement acknowledging their understanding of the infant safe sleep regulations

Exit interview conducted and report was reviewed with Licensee, Lola Foster.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1