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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845737
Report Date: 06/25/2024
Date Signed: 06/25/2024 10:49:19 AM

Document Has Been Signed on 06/25/2024 10:49 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 SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MEDINA FAMILY CHILD CAREFACILITY NUMBER:
334845737
ADMINISTRATOR/
DIRECTOR:		MEDINA,YARAVIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 910-0142
CITY:COACHELLASTATE: CAZIP CODE:
92236
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/25/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Yaravi MedinaTIME VISIT/
INSPECTION COMPLETED:
10:55 AM
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On June 25, 2024, a non- compliance conference was held with licensee Yaravi Medina at the Riverside Regional office. In attendance were licensee Yaravi Medina, Regional Manager (RM) Stephanie Hudak, Licensing Program Manager (LPM) Deborah Mullen, Licensing Program Analyst (LPA) Lorena Valenzuela, and from Riverside office of Education- Coordinator Rosamaria Rodriguez.
The following concerns were discussed with licensee by Regional Manager Stephanie Hudak.
· Operation of a Family Child Care Home regarding lack of supervision of children in care

Regional Manager Stephanie Hudak discussed a compliance plan with the licensee which includes the following:
Licensee agrees to seek outside vendor training with Riverside County Office of Education Resource and Referral, and to complete and/or schedule a compliance training and a training on supervision of children.
Licensee was advised the Department will monitor the licensee’s compliance plan over the next 12 months to verify licensee remains in compliance with licensing laws and regulations. The licensee understands and acknowledges that the Department, at its discretion, will make unannounced inspections over the next 12 months to monitor the compliance of this plan. If the Department determines that the licensee has violated the law or regulations it may refer the facility for revocation or other appropriate administrative action.

Proof of enrollment into all training's must be submitted to the Department within 30 days (07/25/2024) and submit proof of completion within 90 days of today’s conference (09/25/2024).
Licensee Medina agreed with compliance plan and to all recommendations made. Regional Manager Stephanie Hudak advised licensee that although a compliance plan was made and agreed upon, this does not preclude the Department form seeking legal advice from the Department’s legal team and taking additional recommended actions.
A copy of this report was provided to licensee Yaravi Medina for signature. Copy of the signed report, and non-compliance facility plan (LIC9111) appeal rights were provided to licensee Yaravi Medina.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024
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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