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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300653
Report Date: 02/06/2025
Date Signed: 02/06/2025 01:31:07 PM

Document Has Been Signed on 02/06/2025 01:31 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 SE CC RO, 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: 1DATE:
02/06/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Rosaura JimenezTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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On 2/6/25 at 12:30 PM Licensing Program Analyst (LPA) Naomi Hurtado arrived at this facility to conduct an inspect for a capacity increase. Currently the home is licensed for 8 children. Licensee is requesting a capacity increase to 12 or 14 children which was received in the Riverside South East Regional Office on 12/31/25.
• Normal days and hours of operation are: Mon – Fri. 5:00 AM – 5 PM
• Off-limit areas include: Bedrooms, laundry room, and garage.
• Appropriate supervision was being provided during this inspection
• A working telephone is present, and the current phone number is on file
• A fully charged fire extinguisher (2A:10BC) was observed. A smoke detector and carbon monoxide detector were present
• All hazardous items are stored inaccessible to children
• Toxins are locked and inaccessible to children in care.
• Weapons are not present. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations
• Clean, safe, and age-appropriate toys are provided
• Current roster on file
• Facility Sketch, Emergency Disaster Plan and Notification of Parent’s Rights poster are posted
• Documentation of fire and disaster drills are on file – Last drill was conducted 9/8/24
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Naomi Hurtado
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: JIMENEZ FAMILY CHILD CARE
FACILITY NUMBER: 336300653
VISIT DATE: 02/06/2025
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• No bodies of water are present at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
• Verification of control of property is on file
• Children’s records were not reviewed at this time
• There is no current employee/assistants.
• Mandated Reporter Training completed on 6/13/24
• Pediatric CPR and First Aid Card expires on 5/2026
• Health & Safety Certificate - completed on 6/25/22
• Resident and/or staff records were reviewed and all adults who require caregiver background checks have received all required clearances and/or exemptions.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200

The facility was granted a fire clearance on 1/6/25. Based on LPAs inspection the capacity increase is granted at this time. Licensee understands that prior to caring for capacity of 12 or 14 children, Licensee must have a qualified assistant.

An exit interview was conducted, appeal rights, Notice of Site Visit and a copy of this report was provided to the licensee.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Naomi Hurtado
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
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