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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701217
Report Date: 07/29/2020
Date Signed: 07/30/2020 01:20:20 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CONGREGATION BETH ISRAEL/SID RUBIN INFANTFACILITY NUMBER:
376701217
ADMINISTRATOR:CATHY GOLDBERGFACILITY TYPE:
830
ADDRESS:9001 TOWNE CENTRE DRIVETELEPHONE:
(858) 900-2530
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:24CENSUS: 8DATE:
07/29/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Cathy Goldberg TIME COMPLETED:
12:15 PM
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On 07/29/2020 at 12:00pm, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced case management inspection via Face Time due to COVID-19. The purpose of the inspection is to follow-up on an alleged personal rights violation that occurred on 07/23/20. The allegation was that a staff member lifted a toddler by one arm over the classroom door safety gate. The incident was self-reported to Community Care Licensing by the facility within a timely manner on 07/24/2020 and a written report was received within the seven days requirement on 07/28/2020.

Infant staff members and Director were interviewed regarding the alleged incident. Written statements were obtained from the facility. Day care parent was also contacted. Based on information obtained, there is lack of evidence to proof that a child's personal's rights were violated.

The following ratios were observed today: Room 100 had 4 older infants supervised by staff Rachel Phares and Gina Wade. Room 102 had 4 non-mobile infants supervised by staff Stella Ferrari and Monica Becerril. Staff members have the required background clearances and are associated to the facility.

An exit interview was conducted with the Director. The Director was provided a copy of their appeal rights, this report, and the Notice of Site Visit via email. Director was advised to respond to the email confirming receipt of these items. This will act as Director’s signature on today’s inspection report. Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2020
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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