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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334816399
Report Date: 10/28/2025
Date Signed: 10/28/2025 02:03:38 PM

Document Has Been Signed on 10/28/2025 02:03 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:RAWLINS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
334816399
ADMINISTRATOR/
DIRECTOR:		RAWLINS, YASMINFACILITY TYPE:
850
ADDRESS:18215 CLARK STREETTELEPHONE:
(951) 642-8234
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 14DATE:
10/28/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:39 PM
MET WITH:Yasmin RawlinsTIME VISIT/
INSPECTION COMPLETED:
02:15 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 10/28/25, Licensing Program Analysts (LPA), Kelli Waters and Sumayya Habeebulla, conducted an unannounced visit to the facility for a separate unrelated issue. LPAs met with Director, Yasmin Rawlins, conducted a tour of facility, interviewed Licensee and reviewed records.

During record review of 6 staff, LPAs observed that multiple staff’s files were incomplete. LPAs found that 4 out of 6 staff were missing immunization records, 2 out of 6 staff were missing Tuberculosis testing verification, and 3 out of 6 staff were missing a health screening. In addition, 2 out of 6 staff reviewed did not have the required AB 1207 training component for mandated reporting. After requesting the items stated above, the facility was unable to produce the required staff documentation at the time of visit.

Licensee will be cited under California Code of Regulations, Title 22, Personnel Records 101217(a) and Health and Safety Code, 1596.8662(b)(1) and 1596.7995(a)(1).

See 809-D for cited deficiencies.

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

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

NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Kelli Waters
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2025
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 4
Document Has Been Signed on 10/28/2025 02:03 PM - It Cannot Be Edited


Created By: Kelli Waters On 10/28/2025 at 01:47 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAWLINS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 334816399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/25/2025
Section Cited
HSC
1596.7995(a)(1)

1
2
3
4
5
6
7
a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles...

This requirement has not been met as evidenced by:
1
2
3
4
5
6
7
Licensee will have S2, S3, S4, & S5 provide proof of immunizations of measles and pertussis. Licensee will send copies of immunizations to LPA via email and place immunization records in staff’s files.
8
9
10
11
12
13
14
Based on record review, 4 out of 6 staff records reviewed did not have proof of immunizations to measles or pertussis, therefore the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Type B
11/25/2025
Section Cited
CCR101217(a)

1
2
3
4
5
6
7
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening…(12) Tuberculosis test documents…

This requirement has not been met as evidenced by:
1
2
3
4
5
6
7
Licensee will have S3, S4, & S5 provide a health screening and will send proof of health screening to LPA via email. Licensee will have S3 & S4 provide proof of a negative tuberculosis test and wills end proof to LPA via email.
8
9
10
11
12
13
14
Based on record review, 3 out of 6 staff did not have either a health screening or tuberculosis test on file, therefore the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Carlos Martinez
NAME OF LICENSING PROGRAM MANAGER:
Kelli Waters
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2025


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 10/28/2025 02:03 PM - It Cannot Be Edited


Created By: Kelli Waters On 10/28/2025 at 01:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAWLINS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 334816399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/25/2025
Section Cited
HSC
1596.8662(b)(1)

1
2
3
4
5
6
7
(b) (1)   On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement has not been met as evidenced by:
1
2
3
4
5
6
7
Licensee will have S3 & S6 complete the Child Care Provider training component of Mandated Reporter and submit certificates to LPA via email.
8
9
10
11
12
13
14
Based on record review, 2 out of 6 staff had only completed general training which does not meet the AB 1207 requirement, therefore the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Carlos Martinez
NAME OF LICENSING PROGRAM MANAGER:
Kelli Waters
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2025


LIC809 (FAS) - (06/04)
Page: 4 of 4