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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561701544
Report Date: 08/26/2021
Date Signed: 08/26/2021 01:29:24 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:TEMPLE ADAT ELOHIM PRESCHOOLFACILITY NUMBER:
561701544
ADMINISTRATOR:DONNA BECKERFACILITY TYPE:
850
ADDRESS:2420 E. HILLCREST DRIVETELEPHONE:
(805) 497-6920
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:124CENSUS: 43DATE:
08/26/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Donna BeckerTIME COMPLETED:
12:30 PM
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On August 26, 2021 at 11:41 am, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Annual/Random inspection. LPA met with facility Director Donna Becker and advised her the purpose of the inspection. There was 43 children in care at the time of the inspection. The facility operates Monday thru Friday 7:30 am - 6:00 pm. The facility also has an infant program on the premises as well.

LPA observed required licensing documents mounted on the wall in each classroom. There was no menu posted. Children bring two (2) snacks and their lunch from home. The facility will be offering a hot lunch program to families from a local vendor soon at a cost. The center has six (6) classes available for use. LPA observed two (2) restrooms. One restroom had five (5) toilets, one (1) changing table, and five (5) sinks readily accessible to children. The second restroom had two (2) toilets for children to use while in the outdoor playground. LPA did not observe any hazards/toxins items accessible to children in care. Each of the classrooms have age appropriate toys and furniture readily accessible for children. Facility provides children that are staying full day a sleeping mat during quiet time if they choose to sleep. The outdoor playground has an ample amount of space for children to play. LPA observed the playground has age appropriate toys and structures available for children to use. The playground has ample amount of shade available. The facility has water available for children inside and out. Children use their own water bottles from home. The facility refills the water bottles with filtered water periodically. LPA observed where the facility stores medication securely.

Continued on 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: TEMPLE ADAT ELOHIM PRESCHOOL
FACILITY NUMBER: 561701544
VISIT DATE: 08/26/2021
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A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. LPA observed staff files to be complete and current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Teachers meet the required qualifications. Teachers present have current Pediatric CPR/First-Aid certificates that are valid until 8/9/2023. Teachers have current Mandated Reporter certificates that are valid until 1/11/2022. LPA spoke with Director about new Covid-19 guidelines. Facility is currently following Covid-19 guidelines.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation interpretations and procedures for Child Care Centers sections 101173 and 101226. When any IMS is provided, an updated plan of operation that includes IMS must be submitted to the Department. the follow information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA information line at (800) 514-0301 (voice) / (800) 514-0383 (TTY) and link to publication: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies were cited during today's inspection.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
LIC809 (FAS) - (06/04)
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