334805317-9-7-2022-09-CC-GCAO-CJ32JK-20220907172630

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334805317
Report Date: 09/07/2022
Date Signed: 09/07/2022 05:26:41 PM

Document Has Been Signed on 09/07/2022 05:26 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:	TEMPLE BETH EL CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	334805317
ADMINISTRATOR:	TRUDY J OLIVER		FACILITY TYPE:	840
ADDRESS:	2675 CENTRAL AVE		TELEPHONE:	(951) 682-7282
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92506
CAPACITY:	62	CENSUS: 29	DATE:	09/07/2022
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Tonya Soleski, Assistant Director		TIME COMPLETED:	05:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 09/07/22 at 02:30PM a case management visit was conducted in response to the receipt of an unusual incident report (UIR) from the facility on 08/19/22. It indicates staff pushed backpacks and a child’s arm into fencing due to perceived danger along the route from the elementary school to the facility. LPA conducted interviews with pertinent parties involved: Directors, Teachers and children. LPA interviewed 5 staff. According to staff interviewed there was an exposed electrical box along the transition route from the Elementary school to the daycare facility. Staff interviews reported children were instructed to move closer to the fence while walking. Staff interviews denied anyone pushing a child or pulling a child’ arm or backpack or not observing incident. Staff interviews did report that children reported a staff grabbing their back pack; pushing a child’s arm into the fence and that the situation felt like bullying. LPA interviewed 4 children. All Children interviews disclosed that instruction was given to move closer to the fence. Children interviews reported that a staff pulled on 2 children’s backpacks, pushed one child and grabbed the arm of another. Children also reported that the incident made them feel weird and bullied due to staff's comments. Record reviews revealed facility conducted an internal investigation, including meetings with the children, parents, facility administration and staff. Additionally, per facility self-report via the Unusual incident report LIC624, personnel corrective actions were taken including additional training on methods to address behaviors/situations in the future.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: TEMPLE BETH EL CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 334805317
	VISIT DATE: 09/07/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on information gathered from interviews and records, the facility failed to accord dignity to children in care in their personal relationships with staff and other persons; a deficiency has been cited during this visit.

LPA Carbullido informed facility representative Tanya Soleski that this report dated 09/07/2022 document(s) 1 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.

Also, LPA Carbullido informed the facility representative to provide a copy of this licensing report dated 09/07/2022 that documents 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.

An exit interview was conducted, and LPA Carbullido provided Tanya Soleski, Assistant Director with a copy of this report and notice of site visit. This report must be made available to the public upon request for three years.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3

Document Has Been Signed on 09/07/2022 05:26 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: TEMPLE BETH EL CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 334805317
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/07/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/08/2022 Section Cited	1 2 3 4 5 6 7	101223(a)(1) Personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on interviews conducted and records reviewed, the facility did not meet the section above in that the facility did not accord dignity to children in their personal relationships with staff. This is an immediate health and safety risk to persons in care.	8 9 10 11 12 13 14	Facility will submit proof of completion of LIC 9224 for all children enrolled in the school age program.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3