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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300653
Report Date: 07/18/2024
Date Signed: 07/18/2024 12:09:14 PM

Document Has Been Signed on 07/18/2024 12:09 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:JIMENEZ FAMILY CHILD CAREFACILITY NUMBER:
336300653
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 10CENSUS: 5DATE:
07/18/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Rosaura JimenezTIME VISIT/
INSPECTION COMPLETED:
12:13 PM
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On 7/18/2024 at 11:30am, Licensing Program Analyst (LPA) Jeanette Sanchez arrived at the facility to conduct a case management inspection as part of a compliance plan. LPA met with Licensee Rosaura Jimenez.

LPA toured facility, took census and reviewed records. Children were being supervised in the living room at the time of arrival and inspection.

No health or safety concerns were found. There are no deficiencies being cited at this time.

An exit interview was conducted, and this report was reviewed with the licensee Rosaura Jimenez. 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: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2024
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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