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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846129
Report Date: 06/26/2024
Date Signed: 06/26/2024 02:18:23 PM

Document Has Been Signed on 06/26/2024 02:18 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:WAGNER FAMILY CHILD CAREFACILITY NUMBER:
364846129
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
06/26/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Robin Wagner, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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
On 06/26/2024 at 01:15 PM, Licensing Program Analyst (LPA) Raymond Moorehead arrived at the facility to conduct a Case Management visit for the purpose of a capacity increase. Present during this inspection was Licensee, Robin Wagner. LPA toured the facility, inside and out and the following was observed and/or discussed:

Normal days and hours of operation are Monday through Friday from 7:00 AM to 4:00 PM.

OFF-LIMIT AREAS INCLUDE: Kitchen, all bedrooms, garage, bathroom #1.

· Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the licensee during this inspection. Fire extinguisher, smoke detector and carbon monoxide detector are in working order.

· All hazardous items are made inaccessible

· Toxins are locked

· Weapons are present and stored according to Title 22. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations.

· Fireplace is properly screened to prevent access to children

· Storage of poisons are inaccessible to children

· Proof of control of property is on file.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Raymond Moorehead
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WAGNER FAMILY CHILD CARE
FACILITY NUMBER: 364846129
VISIT DATE: 06/26/2024
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
26
27
28
29
30
31
32
· Facility Sketch and Emergency Disaster Plan are posted

· Pediatric CPR and First Aid Card expired on 04/2024 (licensee is registered for a new CPR & 1st Aid course)

·Mandated Reporter Training Certificate expires on 11/19/2025



· Health & Safety Certificate - completed on 07/15/2018

· Fire clearance was granted on 06/25/2024

· Last Fire drill was conducted on 06/03/2024

· Last Earthquake drill was conducted on 06/11/2024


· Clean, safe and age-appropriate toys are present

· There are no toxic plants observed at this time




No bodies of water are present at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

LPA went over the capacity regulations for a large family child care home with Robin Wagner and provided licensee with a copy of the capacity regulations diagram.

Upon final review, the application for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 14 with parent notification.

Exit interview conducted and report was reviewed with Licensee, Robin Wagner. Appeal rights were discussed and provided to the licensee. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Raymond Moorehead
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2