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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845477
Report Date: 09/21/2023
Date Signed: 09/21/2023 10:05:37 AM

Document Has Been Signed on 09/21/2023 10:05 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:MARSHALL FAMILY CHILD CAREFACILITY NUMBER:
364845477
ADMINISTRATOR:MARSHALL, REGINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 648-8160
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
09/21/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Regina MarshallTIME COMPLETED:
10:25 AM
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On date and time listed above Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the facility for another purpose. LPA discussed purpose of visit and was granted access to Facility by Licensee, Regina Marshall.

Licensee has requested to add on-limit space to their day care facility and has supplied LPA with an updated sketch (map) of the facility. Licensee previously had bedrooms #2 and #3 marked as off-limits and non use for day care activities and would now like to add this space.

LPA toured bedrooms #2 and #3 downstairs and did not observe any notable health or safety concerns. Licensee will now be able to utilize this space.

LPA collected updated sketch (map) and will add to the facility file.

Exit interview was conducted and this report was reviewed with Licensee, Regina Marshall.

Notice of site visit was issued and much be posted for the next 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2023
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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