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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561701544
Report Date: 11/15/2024
Date Signed: 11/15/2024 03:38:21 PM

Document Has Been Signed on 11/15/2024 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:TEMPLE ADAT ELOHIM PRESCHOOLFACILITY NUMBER:
561701544
ADMINISTRATOR/
DIRECTOR:		DONNA BECKERFACILITY TYPE:
850
ADDRESS:2420 E. HILLCREST DRIVETELEPHONE:
(805) 497-6920
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY: 124TOTAL ENROLLED CHILDREN: 124CENSUS: DATE:
11/15/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:05 PM
MET WITH:Lindsay WozniakTIME VISIT/
INSPECTION COMPLETED:
03:55 PM
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On 11/15/24, Licensing Program Analyst (LPAs) Veronica Diaz and Sylvia Ceja conducted an unannounced Required-3 year required annual inspection and licensee has request a changed of capacity for the licensed preschool to be decreased to 84 and the toddler component to be increased to 40. LPAs met with director Lindsay Wozniak and advised them of the purpose of the inspection. Director provided LPAs a tour of the facility inside and out. There were 19 children in toddler component and 51 in the preschool in care at the time of the inspection along with 15 staff. Center operates M-F 7:30 AM-5:30PM.

LPAs observed required licensing documents mounted on the walls throughout the facility. Last disaster drill was conducted on 10/22/24. Each of the classrooms have age-appropriate toys and furniture readily accessible for children in care. LPAs observed enough restrooms available for children to use. LPAs did observe cleaning whips and scissors in children's reach. LPAs requested and observed director removing the cleaning whips and scissors above 5 feet and out of children's reach. First Aid kits were observed in a backpack near the classroom door. Currently the facility uses an App called My Brightwheel for parents sign-in and sign-out and a form of communication. Parents provide child with lunch and snacks from home. LPAs observed cubbies with children name label to store their lunch and belongings

The outdoor playground is shaded and has plenty amount of space for children to play. LPAs observed the playground has age-appropriate toys and structures available for children to use.

A sampling of children and staff records were reviewed. LPA observed children's files to be incomplete physician report and immunization report missing from the file. Staff mandated reporter certification are not current LPAs reminded director that staff is required to complete mandated reporter training every 2 years. LPAs verified SB792 Child Care Adult Immunization and Tuberculosis requirements.

Continued on 809-C

Lissete GonzalezTELEPHONE: (805) -56-0400
Veronica DiazTELEPHONE: (805) 562-0400
DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: TEMPLE ADAT ELOHIM PRESCHOOL
FACILITY NUMBER: 561701544
VISIT DATE: 11/15/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.


Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed on 08/03/2022 in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) -56-0400
LICENSING EVALUATOR NAME: Veronica DiazTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: TEMPLE ADAT ELOHIM PRESCHOOL
FACILITY NUMBER: 561701544
VISIT DATE: 11/15/2024
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Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

changed of capacity for the licensed preschool to be decreased to 84 and the toddler component to be increased to 40 is pending restroom waiver and further review.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In today's visit the was 2 type B deficiencies and 2 Technical Violations

Exit interview conducted, appeal rights were given, and report was reviewed with director Lindsay Wozniak .

SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) -56-0400
LICENSING EVALUATOR NAME: Veronica DiazTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
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Document Has Been Signed on 11/15/2024 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117


FACILITY NAME: TEMPLE ADAT ELOHIM PRESCHOOL
FACILITY NUMBER: 561701544

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2024
Plan of Correction
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LPA requested and observed director removing cleaning whips and scissors above 5 feet and out of children's reach.
Section Cited
Child's Medical Assessments
(b) The medical assessment shall provide the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/13/2024
Plan of Correction
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LPA requested director to obtain a physician report and immunization record missing from children's files and submit copy to LPA by email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lissete GonzalezTELEPHONE: (805) -56-0400
Veronica DiazTELEPHONE: (805) 562-0400

DATE: 11/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2024

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