<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845425
Report Date: 03/26/2024
Date Signed: 03/26/2024 05:04:11 PM

Document Has Been Signed on 03/26/2024 05:04 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:PENA-BRISENO FAMILY CHILD CAREFACILITY NUMBER:
334845425
ADMINISTRATOR:AMBAR PENA-BRISENOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 246-8800
CITY:JURUPA VALLEYSTATE: CAZIP CODE:
92509
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
03/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Licensee's Spouse Jose Briseno and Licensee Ambar Pena BrisenoTIME COMPLETED:
05:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On the above date and time, Licensing Program Analyst (LPA) Susan Brewer, arrived at the facility for the purpose of conducting a Case Management inspection regarding a self-reported incident. LPA was greeted by the licensee's spouse and granted entry to tour the facility inside and out. Present were the licensee's spouse and 2 staff. LPA took a census of 5 daycare children present. The following was discussed: The licensee was temporarily away from the facility and joined the inspection at 3:00 PM

On 11/17/2023 the licensee submitted a self-reported incident regarding a client's decision to remove a child due to an allegation that a staff was observed inappropriately disciplining a daycare child. In addition, the authorized representative disputed enrollment fees charged in the admissions agreement. On 12/04/2023 the LPA S. Brewer, conducted an initial investigation into the UIR, reviewed facility records, made observations, conducted interviews and more time was needed to follow up on the UIR. The LPA conducted additional interviews with pertinent parties related to the incident. Based on information gathered no violations have been identified. The LPA was unable to obtain evidence to support the allegation that a staff inappropriately disciplined a day care child. The licensee self-reported the incident regarding the allegation and the dispute over the enrollment fees. In addition, the licensee returned the fees to the authorized representative, following the representative's decision to remove the child from daycare.

No citations were issued regarding this visit. See LIC809 Case Management inspection conducted for a separate matter on today's date for Type B citation issued.
No civil penalties were issued on today’s date.

An exit interview was conducted, and a copy of this report was provided to the licensee Ambar Pena-Briseno.

A Notice of Site Visit was given and must remain posted for 30 days. LPA verified the notice was posted prior to exiting the facility.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/26/2024
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 1