364846066-2-3-2023-09-CC-LMEO-CNPTHP-20230203134416

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364846066
Report Date: 02/03/2023
Date Signed: 02/03/2023 01:44:18 PM

Document Has Been Signed on 02/03/2023 01:44 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:	PSD/MILL CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	364846066
ADMINISTRATOR:	SOARES, CHERYL		FACILITY TYPE:	850
ADDRESS:	205 SOUTH ALLEN STREET		TELEPHONE:	(909) 383-2025
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92408
CAPACITY: 160	TOTAL ENROLLED CHILDREN: 160	CENSUS: 71	DATE:	02/03/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	12:12 PM
MET WITH:	Cheryl Soares		TIME COMPLETED:	01:00 PM

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Licensing Program Analyst (LPA) Laura Mejorado arrived at the facility to conclude a case management inspection in response to the receipt of an unusual incident report (UIR) which was initiated on 12/28/22. The UIR was received by the Riverside Child Care Regional office and documented an incident where a child fell off their bike and sustained an Injured arm which require medical attention.

Upon arrival, LPA met with Director Cheryl Soares and stated the purpose of the visit. Throughout the investigation records were reviewed and interviews were conducted with the supervising staff at the time of the incident. During todays inspection the subject child was sleeping and an interview was not able to be completed. LPA inspected the black top/bike area where the incident occurred.

Based on the information gathered and compiled during this investigation, there are no violations of Title 22 Regulations at this time.

Exit interview conducted and report was reviewed with Director Cheryl Soares.

A notice of site visit was given and must remain posted for 30 days.

A copy of this report must be made available to the public, at the facility site, for 3 years.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

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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