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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830940
Report Date: 09/25/2024
Date Signed: 09/25/2024 11:07:40 AM

Document Has Been Signed on 09/25/2024 11:07 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 SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:THEDFORD FAMILY CHILD CAREFACILITY NUMBER:
334830940
ADMINISTRATOR/
DIRECTOR:		THEDFORD, KEICHELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 377-3671
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:56 AM
MET WITH:Keichel Thedford, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
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On 9/25/2024 at 10:56 AM, Licensing Program Analyst (LPA) Jesse Gardner arrived unannounced to conduct a case management visit to deliver an amended complaint report dated 07/31/2024.

LPA met with Licensee Keichel Thedford and toured the facility. At the conclusion of the tour, LPA noted no deficiencies.

An exit interview was conducted, and this report was reviewed with Licensee Keichel Thedford. Appeal rights were discussed and provided during the exit interview. A notice of site visit was provided and must remain posted for 30 days.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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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