<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372001648
Report Date: 11/13/2023
Date Signed: 11/13/2023 03:38:10 PM


Document Has Been Signed on 11/13/2023 03:38 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:SILVERMAN PRESCHOOL OF TIFERETH ISRAEL SYNAGOGUEFACILITY NUMBER:
372001648
ADMINISTRATOR:JENNIFER LOWFACILITY TYPE:
850
ADDRESS:6660 COWLES MOUNTAIN BOULEVARDTELEPHONE:
(619) 697-1948
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY:89CENSUS: 48DATE:
11/13/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:01 PM
MET WITH:Antonio ParkerTIME COMPLETED:
04:00 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 11/13/2023, Licensing Program Analysts Nancy Diaz and Sherlynn Banas conducted an unannounced case management inspection. LPAs conducted a tour of the classrooms with Antonio Parker, Ass't Director. Observed present today were 48 preschool children in classroms #3, #8, #10, #12 & #14.

Interviews were conducted with several staff including Mr. Parker. LPAs also reviewed all staff files. File review conducted today indicated that several staff's fingerprint clearance are not associated to the facility. Several staff are also missing Physician's Reports, Immunization and Mandated Reporter Training certificates.

Type B deficiencies are being cited on the attached LIC 809D.

Exit interview was conducted with Antonio Parker. LPA reviewed and provided a copy of this report to Mr. Parker. Appeal rights and Notice of Site visit were also provided. Notice of Site visit must remain posted for 30 days.
SUPERVISOR'S NAME: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 929-2327
LICENSING EVALUATOR SIGNATURE:
DATE: 11/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2023
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 4


Document Has Been Signed on 11/13/2023 03:38 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: SILVERMAN PRESCHOOL OF TIFERETH ISRAEL SYNAGOGUE
FACILITY NUMBER: 372001648

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/13/2023
Section Cited
CCR
101170(e)

1
2
3
4
5
6
7
CRIMINAL RECORD CLEARANCE. (e) All individuals subject to a criminal record review ...shall prior to working, residing or volunteering in a licensed facility...(2) Request a transfer of a criminal record clearance
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Mr. Parker stated that he will submit form to request staff to be associated to the facility immediately but no later than 11/14/23.
8
9
10
11
12
13
14
Based on record review, facility failed to associate 4 staff's livescan fingerprint to the facility - Gabriela Leon (Employed 8/1/23); Rocio Leon (Employed 5/8/23); Katelyn Salisbury and Rouwaida Nouri) (first day 11/13/23)
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 929-2327
LICENSING EVALUATOR SIGNATURE:
DATE: 11/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4


Document Has Been Signed on 11/13/2023 03:38 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: SILVERMAN PRESCHOOL OF TIFERETH ISRAEL SYNAGOGUE
FACILITY NUMBER: 372001648

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/20/2023
Section Cited
CCR
101216(g)(1)

1
2
3
4
5
6
7
PERSONNEL REQUIREMENTS. Except as specified in (3) below, good physical health shall be verified by a health screening,...performed by or under the supervision of a physician...


This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Mr. Parker shall obtain copies of required staff physical documentation and submit copies to the department no latger than 11/20/23.
8
9
10
11
12
13
14
Based on record review several staff were missing Physicals: Jean Simon; Mary Rodriguez; Even Sabri; Katelyn Elleraas and Sinia Fruge.
8
9
10
11
12
13
14
Type B
11/20/2023
Section Cited
HSC1596.7995

1
2
3
4
5
6
7
Health and Safety Code...1596.7995(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Mr. Parker stated that he will obtain copies of staff immunization and submit to the department no later than 11/20/23.
8
9
10
11
12
13
14
Based on record review, several staff were missing the required immunization (Pertussis, Measles & Influenza): Jean Simon; Mary Rodriguez; Margarita Torres and Bianca Martinez.
8
9
10
11
12
13
14
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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 929-2327
LICENSING EVALUATOR SIGNATURE:
DATE: 11/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4


Document Has Been Signed on 11/13/2023 03:38 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: SILVERMAN PRESCHOOL OF TIFERETH ISRAEL SYNAGOGUE
FACILITY NUMBER: 372001648

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/20/2023
Section Cited
HSC
1596.8662

1
2
3
4
5
6
7
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to...
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Mr. Parker shall obtain proof of course completion and submit copies to the department no later than 11/20/23.
8
9
10
11
12
13
14
Based on record review, several staff were missing the required Mandated Reporter Training certificate: Jean Simon; Mary Rodriguez; Margarita Torres; Jessica Wheeler; Even Sabri; Karla Lora and Katie Edwards.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 929-2327
LICENSING EVALUATOR SIGNATURE:
DATE: 11/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4