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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334814895
Report Date: 06/10/2024
Date Signed: 06/10/2024 04:13:08 PM

Document Has Been Signed on 06/10/2024 04:13 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 SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ABC CHILD CARE VILLAGEFACILITY NUMBER:
334814895
ADMINISTRATOR/
DIRECTOR:		ANGELINE ANTON (ANGEL)FACILITY TYPE:
830
ADDRESS:40045 VILLAGE ROADTELEPHONE:
(951) 491-0940
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY: 47TOTAL ENROLLED CHILDREN: 47CENSUS: 37DATE:
06/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:11 PM
MET WITH:Candice Lawrence TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 06/10/2024 at 1:50 pm, Licensing Program Analysts (LPAs) Gabriela Hernandez and Kelli Waters conducted an unannounced case management visit in regards to an unusual incident report received on 04/24/24. LPAs met with Director Candice Lawrence.

Per incident report and interview with Director, C1 was given a few sips of C2’s bottle accidently by a staff member providing breaks for primary care teacher. Per Director, C1’s and C2’s parent were notified of the incident. LPA’s observed the classroom and children’s refrigerator where bottles were stored. The bottles were labeled with children’s names. The bottles were placed in the primary care teachers basket on the counters and the refrigerator. LPA’s reviewed children files, an infant intake form was observed. Based on the information gathered, the facility acted appropriately, and no violations have been identified.

During case management visit, LPA’s discussed the safe sleep regulations and Infant Sleep Plan.

An exit interview was conducted and a copy of this report and appeal rights were provided to the Director.



A notice of site visit was given and shall remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Gabriela Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2024
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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