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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846261
Report Date: 03/07/2023
Date Signed: 03/07/2023 01:13:52 PM

Document Has Been Signed on 03/07/2023 01:13 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:OLIVE TREE DAY SCHOOLFACILITY NUMBER:
364846261
ADMINISTRATOR:WEGLEY, KELLYFACILITY TYPE:
850
ADDRESS:7690 ARCHIBALD AVETELEPHONE:
(909) 987-6264
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY: 55TOTAL ENROLLED CHILDREN: 55CENSUS: 0DATE:
03/07/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Kelly Wegley/licenseeTIME COMPLETED:
02:06 PM
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On 3/7/23 at 12:40 pm, Licensing Program Analyst (LPA) Patricia Berry conducted a case management licensee initiated to inspect a classroom that will be used for music, and other extra curricular activities. LPA observed no children present during inspection. LPA inspected the classroom that will be used. The classroom meets Title 22 regulations. Licensee will comply with appropriate ratios and supervision while children are in the classroom. Licensee will comply with regulations regarding third party contractors.The Rancho Cucamonga fire department approved the room for use for the daycare on 2/27/23.


Exit interview conducted with licensee, report, appeal rights and notice of site visit issued.



Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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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