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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330907346
Report Date: 06/11/2024
Date Signed: 06/11/2024 11:53:04 AM

Document Has Been Signed on 06/11/2024 11:53 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CORONA-NORCO FAMILY YMCAFACILITY NUMBER:
330907346
ADMINISTRATOR/
DIRECTOR:		LIZABETH BARRERA DE RUIZFACILITY TYPE:
850
ADDRESS:1331 RIVER ROADTELEPHONE:
(951) 736-9622
CITY:CORONASTATE: CAZIP CODE:
92880
CAPACITY: 77TOTAL ENROLLED CHILDREN: 77CENSUS: 0DATE:
06/11/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:57 AM
MET WITH:Natalie Maldonado, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analyst Elyse Jones arrived at the facility for the purpose of interviewing child(ren) regarding other matters at another facility. Interview(s) were conducted.

No deficiencies cited during this inspection.

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.

Exit interview conducted and report was reviewed with Natalie Maldonado, Site Supervisor.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2024
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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