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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830112
Report Date: 04/02/2024
Date Signed: 04/02/2024 09:26:55 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/02/2024 09:26 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ARAGON FAMILY CHILD CAREFACILITY NUMBER:
334830112
ADMINISTRATOR:ARAGON, ANGEL & ROSALINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 769-1124
CITY:BEAUMONTSTATE: CAZIP CODE:
92223
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:56 AM
MET WITH:Licensee ANGEL & ROSALINDA ARAGONTIME COMPLETED:
09:37 AM
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On 4-2-2024 and time listed above, Licensing Program Analyst (LPA) Steven Montoya arrived at the facility to conduct an annual inspection. LPA was granted entry by Licensee, Angel and Rosalina Aragon. LPA toured the home, inside and out, reviewed records, and observed and/or discussed the following.

Licensee request termination of license (surrender) effective 4-2-2024. Licensee reports having no children and not interested in continuing care.

Exit.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Steven Montoya
LICENSING EVALUATOR SIGNATURE: DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/02/2024
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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