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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819638
Report Date: 06/11/2021
Date Signed: 06/17/2021 11:51:50 AM

Document Has Been Signed on 06/17/2021 11:51 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:FONSECA FAMILY CHILD CAREFACILITY NUMBER:
334819638
ADMINISTRATOR:FONSECA, ROSARIOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 849-2124
CITY:CABAZONSTATE: CAZIP CODE:
92230
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
06/11/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Rosario Fonseca TIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Timeka Reed arrived to the home for the purpose of inspecting a room addition to the home.
The licensee added "sun room" to the home. The licensee will utilize the room as an additional area for day care children to have both indoor and outdoor activities. The room is equipped with a separate air conditioning unit that was turned on and is in good working order during this inspection.
The room is equipped with age appropriate toys for children. The room also has a functional bathroom for children's use.
There is an appropriate fire extinguisher. The home is equipped with smoke detector and carbon monoxide detector. Both are in working order.
During this inspection, LPA observed that the facility is operating with appropriate ratio and capacity. Poisons and toxins are properly stored and/or locked. There are no bodies of waters observed on this day. There are no guns or weapons in the home.
The room is observed to be appropriate for day care use.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Timeka Reed
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2021
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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