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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843182
Report Date: 02/16/2024
Date Signed: 02/16/2024 03:08:00 PM

Document Has Been Signed on 02/16/2024 03:08 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:CASTELLANOS FAMILY CHILD CAREFACILITY NUMBER:
364843182
ADMINISTRATOR:CASTELLANOS, JANETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 714-5086
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
02/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Jocelyn Gomez TIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Aman Sharma arrived at the facility to conduct a case management visit. The home was toured, and census was taken.

This is an case management visit to amend the facility evaluation report dated February 8, 2024. The amendment is based removal of 2 Type A citations and 2 civil penalties of $500 each.

An exit interview was conducted with the licensee, Jocelyn Gomez. A copy of this report and Notice of Site Visit were provided. The notice of site visit must remain posted on, or immediately adjacent to, the interior side of the main door for 30 consecutive days.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2024
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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