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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841321
Report Date: 07/19/2023
Date Signed: 07/19/2023 09:43:06 AM

Document Has Been Signed on 07/19/2023 09:43 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:RIVERA-CABRERA FAMILY CHILD CAREFACILITY NUMBER:
364841321
ADMINISTRATOR:RIVERA-CABRERA, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 672-7204
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Silvia RiveraTIME COMPLETED:
09:50 AM
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On 7/19/2023 at 08:45 AM, Licensing Program Analyst (LPA) Claudia Caywood arrived at the facility to conduct an annual inspection. Upon arrival, LPA was met by Silvia Rivera, who stated they did not have any children presently enrolled at the facility and requested to be placed on inactive. LPA printed an inactive form and had the licensee complete and sign it.

No deficiencies cited.

An exit interview was conducted, and report was reviewed with the licensee, Silvia Rivera. A Notice of Site Visit was issued and is to be posted in a prominent location at the facility for the next 30 days.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2023
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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