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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005131
Report Date: 05/18/2026
Date Signed: 05/18/2026 12:15:29 PM

Document Has Been Signed on 05/18/2026 12:15 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:BALDERRAMA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
372005131
ADMINISTRATOR/
DIRECTOR:		MENDOZA, JESUSFACILITY TYPE:
850
ADDRESS:709 SAN DIEGO ST.TELEPHONE:
(760) 757-1931
CITY:OCEANSIDESTATE: CAZIP CODE:
92058
CAPACITY: 80TOTAL ENROLLED CHILDREN: 48CENSUS: 43DATE:
05/18/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Jesus Mendoza, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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On 05/18/2026, Licensing Program Analyst (LPA), Tricia Danielson conducted an unannounced case management visit to follow up on Unusual Incident Report (UIR) that the facility self reported to the Department on 05/06/2026 concerning an incident that took place on 05/01/2026. LPA met with Site Supervisor Jesus Mendoza, to discuss the incident. At the time of today's visit, the facility had 48 children enrolled and 43 were present.
Site Supervisor Mendoza reported that on 05/01/2026, the seahorse classroom began the transition process from the playground back into the building following outdoor play. Child #1 (C1) did not fully complete the transition with the class and remained on the playground prior to the door being closed. LPA was able to view video footage of the incident. The footage appeared to indicate C1 returned to the sandbox area of the playground which is immediately in front of the entrance door to the building. After approximately two to three minutes and after the class had entered the building, C1 exited the sandbox and climbed the play structure and was not entirely visible to the camera. After approximately two additional minutes, C1 left the play structure and returned to the door at which time C1 was observed by staff and retrieved. The video footage indicated C1 was carrying their name tag which is part of the transition procedure. LPA also physically inspected the playground and observed all fencing and gates to be secure. The footage also indicated there was no inclement weather at the time of the incident.
Based on LPA's observations, no citation will be issued. An exit interviewed was conducted and a copy of this report was provided along with Appeal Rights and an LIC 9213- Notice of Site Visit which must be posted for 30 days from today's date.
NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Tricia Danielson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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