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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842337
Report Date: 09/18/2019
Date Signed: 09/18/2019 10:48:42 AM

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:CHILDRENS LIGHTHOUSE LEARNING CENTERFACILITY NUMBER:
334842337
ADMINISTRATOR:TARA MARTINEZFACILITY TYPE:
840
ADDRESS:23656 CLINTON KEITH ROADTELEPHONE:
(951) 600-9395
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY:45CENSUS: 6DATE:
09/18/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Tara Martinez, DirectorTIME COMPLETED:
11:00 AM
NARRATIVE
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Program Analyst (LPA) Timeka Reed met with Director, Tara Martinez in order to conduct a case management in response to results of a complaint investigation. During the complaint investigation, it was found that the facility failed to report a change of Director. A records review and an interview with S1 and S2 indicated that in the interim of hiring a permanent director, S3 was assigned as the acting or interim director sometime in April 2019. Community Care Licensing (CCL) was not notified of this change. S2 was hired as the permanent Director according to records provided in July 2019. According to S1, CCL was notified via fax of this change. However, the facility could not provide verification that the change had been reported to the department within 10 days. It should also be noted that upon requesting verification of qualifications of S3, the facility did not have verification readily available to LPA.

See LIC809D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12.
An exit interview was conducted, appeal rights discussed, and a copy of this report was provided to Tara Martinez.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019
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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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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHILDRENS LIGHTHOUSE LEARNING CENTER
FACILITY NUMBER: 334842337
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/23/2019
Section Cited

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Reporting Requirements. The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care
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center director or designee(s).within 10 days of a change of child care center director or designee(s). This requirement was not met as evidenced by a review of facility records which indicated that a facility director was hired without Community Care Licensing notification.
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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: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Timeka ReedTELEPHONE: (951) 970-1161
LICENSING EVALUATOR SIGNATURE:
DATE: 09/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2019
LIC809 (FAS) - (06/04)
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