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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844177
Report Date: 02/07/2024
Date Signed: 02/07/2024 09:25:15 AM

Document Has Been Signed on 02/07/2024 09:25 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:PINEDA FAMILY CHILD CAREFACILITY NUMBER:
334844177
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
02/07/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Eva PinedaTIME COMPLETED:
09:35 AM
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On February 7, 2024 at 8:50AM, Licensing Program Analyst (LPA) William Chancellor conducted a unannounced visit to conduct a Case Management visit to follow up on progress of fire inspection clearance and required visits by the department. LPA met with licensee Eva Pineda, a tour was provided of the entire home and appropriate ratios and capacity’s were observed at this time. LPA observed six children, including one infant. LPA discussed other information with licensee as well.

This report was reviewed with licensee Eva Pineda.

A notice of site visit was provided and must remain posted for 30 consecutive days days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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