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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842375
Report Date: 04/29/2024
Date Signed: 04/29/2024 09:47:39 AM

Document Has Been Signed on 04/29/2024 09:47 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:VVUSD MEAD VALLEY ELEMENTARYFACILITY NUMBER:
334842375
ADMINISTRATOR/
DIRECTOR:		ANDREA RODICH-VITEKFACILITY TYPE:
850
ADDRESS:21100 OLEANDER AVENUETELEPHONE:
(951) 940-8530
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 37DATE:
04/29/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:28 AM
MET WITH:Terri Villareal TIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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This is an amended report to a visit conducted on 04/17/2024.

On today's date and time stated above, Licensing Program Analyst (LPA) Sumayya Habeebulla made an unannounced visit for a Case Management visit at VVUSD Mead Valley to deliver an amended report for Case Management report conducted on 04/17/2024.



LPA met with Terri Villareal to correct errors in the report pertaining to the deficiency of the report.

Facility was toured and census was taken.

An exit interview was conducted, signatures were obtained for the amended page and a copy of this report was provided to Terri Villareal.

A notice of site visit was also provided, and facility representative was reminded the notice must be posted for 30 consecutive days.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2024
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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