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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300782
Report Date: 11/01/2023
Date Signed: 11/01/2023 08:54:36 AM

Document Has Been Signed on 11/01/2023 08:54 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:RODRIGUEZ FAMILY CHILD CAREFACILITY NUMBER:
336300782
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/01/2023
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Danita Rodriguez, Licensee/DirectorTIME COMPLETED:
09:00 AM
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Licensing Program Analyst (LPA) Tricia Danielson and Licensing Program Manager (LPM) Deborah Mullen arrived announced to the facility to conduct a case management visit for the purpose of finalizing prelicensing requirements. LPA and LPM met with Licensee (LIC) Danita Rodriguez.

During today's visit, LPA and LPM toured the backyard of the facility to inspect the fencing surrounding the pool. The fence now meets regulatory requirements. All prelicensing requirements have now been completed.

An exit interview was conducted and a copy of this report was provided to LIC Rodriguez.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Tricia Danielson
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2023
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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