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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300078
Report Date: 06/28/2023
Date Signed: 06/28/2023 10:18:46 AM

Document Has Been Signed on 06/28/2023 10:18 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:DIBBELL FAMILY CHILD CAREFACILITY NUMBER:
336300078
ADMINISTRATOR:MARIBEL DIBBELLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 600-2043
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 5DATE:
06/28/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Maribel DibbellTIME COMPLETED:
08:25 AM
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Licensing Program Analyst (LPA) James Wilkerson arrived at this facility to conducted interviews with children regarding a different facility.

Interviews were conducted.

An exit interview was conducted, appeal rights discussed and provided along with a Notice of Site Visit being posted and a copy of this report was provided on this date.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: James Wilkerson
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2023
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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