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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843309
Report Date: 12/07/2021
Date Signed: 12/07/2021 02:29:14 PM

Document Has Been Signed on 12/07/2021 02:29 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ZAMORA FAMILY CHILD CAREFACILITY NUMBER:
334843309
ADMINISTRATOR:SUSANA ZAMORAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 565-7799
CITY:BERMUDA DUNESSTATE: CAZIP CODE:
92203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 3CENSUS: 3DATE:
12/07/2021
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Susana ZamoraTIME COMPLETED:
02:46 PM
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Licensing Program Analysts (LPAs) Jeanette Sanchez and Ana Noble made an unannounced visit to the facility to conduct a Case Management Legal/Non-Compliance inspection, per the Decision & Order, which was effective as of 2/08/2019. LPAs conducted COVID-19 screening questions prior to entry. LPAs met with Licensee Susana Zamora.

LPAs conducted a tour of the facility. LPAs observed 2 daycare children napping plus licensee's daughter, which were under the care and supervision of Licensee. LPAs also reviewed facility and children files. As a result of the observations made and files reviewed during today’s inspection, it was determined that there were no infants enrolled at the facility.

Facility was found to be in substantial compliance in accordance to probationary terms and Title 22 regulations.



An exit interview was conducted. The appeal rights were discussed and provided along with a copy of this report to Licensee Susana Zamora on this date. A Notice of Site Visit was posted.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2021
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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