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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191690081
Report Date: 02/07/2025
Date Signed: 02/07/2025 03:13:49 PM

Document Has Been Signed on 02/07/2025 03:13 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SINAI TEMPLE AKIBA PRE-SCHOOLFACILITY NUMBER:
191690081
ADMINISTRATOR/
DIRECTOR:		SARAH KLINGERFACILITY TYPE:
850
ADDRESS:10400 WILSHIRE BLVD.TELEPHONE:
(310) 481-3270
CITY:LOS ANGELESSTATE: CAZIP CODE:
90024
CAPACITY: 259TOTAL ENROLLED CHILDREN: 203CENSUS: 181DATE:
02/07/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH: Associate Director Jennifer Cavalieri TIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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An unannounced Case Management-Incident inspection was conducted on this date by Licensing Program Analyst (LPA) Amelia Morales to follow up on an Unusual Incident which occurred on 1/29/2025 and was reported via phone on 2/3/2025 to Community Care Licensing. LPA arrived at the facility and met with Director Jennifer Pearlman and Associate Director Jennifer Cavalieri who guided LPA on a tour of the facility. Due to time constraint Jennifer Pearlman had to step out.

Census: Room #77: there were 19 children with 3 staff; room #78: 19 children with 3 staff; room #75: 16 children with 3 staff; room #76: 14 children with 3 staff; room #52 : 14 children with 3 staff; room #54: 12 children 2 staff; room #56: 13 children with 3 staff; room# 58: 11 children with 3 staff; room#60: 14 children with 2 staff; room #55: 16 with 3 staff; room #57: 16 children with 3 staff; toddler room#112: 11 children with 3 staff and toddler room #114 with 10 children and 3 staff.

Incident: A child fell and fractured their arm from jumping off the playground structure.

During staff interviews it was discovered that no staff had active supervision of the child who obtained an injury. LPA advised that no child(ren) shall be left without the supervision of a teacher at any time.

During the inspection, LPA obtained a copy of the child care facility roster, staff roster, and conducted interviews with staff, took photos and made observations of the play structure where the incident occurred.

LPA Morales informed licensee or facility representative Associate Director Jennifer Cavalieri that this report dated (2/7/2025) documents (number of type A CITATION) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 02/07/2025 03:13 PM - It Cannot Be Edited


Created By: Amelia Morales On 02/07/2025 at 12:10 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SINAI TEMPLE AKIBA PRE-SCHOOL
FACILITY NUMBER: 191690081

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/21/2025
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary...
(1) No child(ren) shall be left without the...Supervision shall include visual observation.

This Requirement has not been met as evidence by
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Director will have a staff meeting and discuss the supervsison expectations.
Facility will submit to LPA via email a copy of the staff meetings agenda and what was discussed.
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Based on interviews with staff there was no supervison provided, to the child that was injured.
This poses a potential health, saftey, or personal rights risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Betty Bell
LICENSING EVALUATOR NAME:Amelia Morales
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2025


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SINAI TEMPLE AKIBA PRE-SCHOOL
FACILITY NUMBER: 191690081
VISIT DATE: 02/07/2025
NARRATIVE
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Also, LPA Morales informed the facility representative Associate Director Jennifer Cavalieri to provide a copy of this licensing report dated (02/7/2025) that document any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

There was a type A citation issued during today’s inspection.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted with the Associate Director Jennifer Cavalieri and a copy of this report was provided along with the Appeals Rights.

















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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC809 (FAS) - (06/04)
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