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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364814242
Report Date: 05/31/2022
Date Signed: 05/31/2022 04:50:17 PM

Document Has Been Signed on 05/31/2022 04:50 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:BOOKER FAMILY CHILD CAREFACILITY NUMBER:
364814242
ADMINISTRATOR:BOOKER, REGINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 268-1949
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/31/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Regina BrookerTIME COMPLETED:
04:50 PM
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Licensing Program Analyst (LPA) Diana Brasel arrived at facility originally on 05/27/2022 to conduct a 1 year annual visit. The licensee wasn't home on 05/27/2022. The licensee contacted LPA to advise that she is currently working outside of the residence.
LPA arrived today to conduct a Case Management visit. LPA provided the Safe Sleep regulations to the licensee, section 102425. The facilities fees are current as of today. LPA obtained an updated LIC 279 and the licensee's CPR and First is current. LPA reviewed the AB 1207 guidelines with the licensee, it was agreed that the licensee would submit proof of completion of the Child Care Provider and General courses no later than June 30, 2022.
· LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
· Please subscribe at www.[email protected] to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
· The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).
LPA obtained a completed LIC 9211 for processing.
A notice of site visit was given on this date.
A copy of this report was provided to the licensee on this date and must be made available to the public upon request for the next 3 years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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