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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366427612
Report Date: 09/16/2021
Date Signed: 09/16/2021 11:02:03 AM

Document Has Been Signed on 09/16/2021 11:02 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:INNOVATIVE BUSINESS PARTNERSHIPS INCFACILITY NUMBER:
366427612
ADMINISTRATOR:KRAGNESS, THERESE MFACILITY TYPE:
775
ADDRESS:17185 YUMA STREETTELEPHONE:
(760) 243-1400
CITY:VICTORVILLESTATE: CAZIP CODE:
92393
CAPACITY: 165CENSUS: 0DATE:
09/16/2021
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Therese Kragness - Licensee/AdministratorTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility and met with Licensee/Administrator Therese Kragness in order to obtain another copy of security footage regarding an incident that happen on 10/29/2019 at the day program, which is in connection with a complaint unrelated to this facility (#18-AS-20191108100012). Kragness provide LPA Colvin with a USB drive which had a copy of the four surveillance recordings. LPA Colvin struggled to get the files to play on her laptop or another facility computer, but was able to view them on one facility computer and took video of the footage using her cell phone as well.

LPA Colvin conducted an exit interview with Licensee/Administrator Therese Kragness and a copy of this report was provided.

SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2021
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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