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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830600
Report Date: 09/06/2023
Date Signed: 09/06/2023 11:25:04 AM

Document Has Been Signed on 09/06/2023 11:25 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:VOLUNTEERS OF AMERICAFACILITY NUMBER:
364830600
ADMINISTRATOR:RUBY CALDERONFACILITY TYPE:
850
ADDRESS:304 N. PEPPER AVENUETELEPHONE:
(909) 562-0901
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY: 190TOTAL ENROLLED CHILDREN: 190CENSUS: 46DATE:
09/06/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Ruby CalderonTIME COMPLETED:
11:35 AM
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On this date and time, Licensing Program Analyst (LPA) Laura Mejorado arrived at the facility to conduct a Case Management inspection regarding a Decision and Order which was ordered on August 31, 2023, and will become effective on September 11, 2023. The Decision and Order is regarding the exclusion of Juliett Garcia, who was employed at the facility. The purpose for the inspection was explained to Director Ruby Calderon. LPA toured the facility and took a census. The subject, Juliett Garcia was not observed at the facility and their last date of employment was February 12, 2019.

A copy of the Decision and Order was mailed out to the Respondent on August 31, 2023, and an additional copy was provided to the Director during today’s inspection. Director acknowledged receipt and understanding of the Decision and Order which reads: Respondent Juliett Garcia is prohibited from employment in, presence in, and contact with clients of, any facility licensed by the Department, certified or approved by a licensed foster family agency, or any resource family home, and from holding the position of member of the board of directors, executive director, or officer of the license of any facility licensed by the Department, for the remainder of Respondent’s life.

No deficiencies cited during today’s inspection.



A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with Director Ruby Calderon.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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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