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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843599
Report Date: 04/16/2024
Date Signed: 04/16/2024 12:06:49 PM

Document Has Been Signed on 04/16/2024 12:06 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:LEDEZMA FAMILY CHILD CAREFACILITY NUMBER:
334843599
ADMINISTRATOR/
DIRECTOR:		MERERY LEDEZMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 625-3899
CITY:INDIOSTATE: CAZIP CODE:
92201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 4DATE:
04/16/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:35 AM
MET WITH:Merery LedezmaTIME VISIT/
INSPECTION COMPLETED:
12:11 PM
NARRATIVE
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On 4/16/2024, Licensing Program Analyst (LPA) Jeanette Sanchez arrived at the facility for an unrelated complaint investigation. LPA met with licensee Merery Ledezma.

During the inspection, it was discovered that a child present was not on the roster and did not have an of the required documents on file.

See LIC809D for deficiency.

An exit interview was conducted, and this report was reviewed with the licensee Merery Ledezma. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 04/16/2024 12:06 PM - It Cannot Be Edited


Created By: Jeanette Sanchez On 04/16/2024 at 11:47 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 334843599

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/19/2024
Section Cited
CCR
102417(g)(8)

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102417 Operation of a Family Child Care Home (8) Each family child care home shall have a current roster of children...This requirement was not met as evidence by:
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Licensee will to LPA a copy of the updated roster by 4/19/2024.
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A child present during the inspection was not on the roster, which poses a potential health, safety or personal rights risk to persons in care.
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Type B
04/19/2024
Section Cited
CCR102417(g)(7)

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102417 Operation of a Family Child Care Home (7) An emergency information card shall be maintained for each child...This requirement was not met as evidenced by:
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Licensee will submit to LPA a copy of the child's file by 4/19/2024.
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A child present during the inspection did not have any required documents on file, which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Deborah Mullen
LICENSING EVALUATOR NAME:Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2