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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701313
Report Date: 02/02/2022
Date Signed: 02/02/2022 03:23:17 PM

Document Has Been Signed on 02/02/2022 03:23 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:EES VISTA INNOVATION EARLY EDUCATION CENTERFACILITY NUMBER:
376701313
ADMINISTRATOR:ABBEY CANUMFACILITY TYPE:
850
ADDRESS:836 OLIVE AVENUETELEPHONE:
(760) 726-2170
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 25DATE:
02/02/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:16 PM
MET WITH: Director Melissa DuffyTIME COMPLETED:
03:33 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Otsanya Cameron and Anastasia Flores arrived at the facility to conduct a case management inspection. The purpose of this visit is to follow-up on Unusual Incident Reports(UIRs) submitted to Community Care Licensing (CCL) by the facility on or around 1/5/2022.

LPAs Interview staff and children on this date.

Based on the interviews, documentation, and information obtained during the course of this visit, there is no indication that a violation of Title 22 Regulations occurred.

An exit interview was conducted with Melissa Duffy and a copy of this report was provided.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Otsanya Cameron
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2022
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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