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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
334840299
Report Date:
07/20/2023
Date Signed:
07/20/2023 10:20:45 AM
Document Has Been Signed on
07/20/2023 10:20 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 STREET, STE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
EMAGINE U AT PLAY
FACILITY NUMBER:
334840299
ADMINISTRATOR:
BEATRICE METELLUS
FACILITY TYPE:
850
ADDRESS:
14420 ELSWORTH STREET #106
TELEPHONE:
(951) 656-3490
CITY:
MORENO VALLEY
STATE:
CA
ZIP CODE:
92553
CAPACITY:
29
TOTAL ENROLLED CHILDREN:
50
CENSUS:
22
DATE:
07/20/2023
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
10:00 AM
MET WITH:
Director, Crystal Edwards
TIME COMPLETED:
10:25 AM
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THIS IS AN AMMENDED REPORT TO MAKE CORRECTIONS ON THE CITATION THAT WAS ISSUED ON 6-13-23.
Licensing Program Analyst (LPA) Linda Almaraz and Licensing Program Manager (LPM) Carlos Martinez arrived at the facility to issue an amended LIC809D for an annual visit conducted on 6/13/23. At this time LPA granted an extension for the plan of correction until 8/1/23. A plan will be put in place for when children are playing on the playground to ensure the safety of the children. Licensee provided the written and signed plan to LPA during this visit.
A notice of site visit was provided and shall remain posted for 30 days. An exit interview was conducted and appeal rights were provided.
SUPERVISORS NAME
:
Carlos Martinez
LICENSING EVALUATOR NAME
:
Linda M Almaraz
LICENSING EVALUATOR SIGNATURE
:
DATE:
07/20/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/20/2023
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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