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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330900842
Report Date: 08/19/2024
Date Signed: 08/19/2024 10:27:32 AM

Document Has Been Signed on 08/19/2024 10:27 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:TEMPLE BETH EL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
330900842
ADMINISTRATOR/
DIRECTOR:		TRUDY OLIVERFACILITY TYPE:
850
ADDRESS:2675 CENTRAL AVENUETELEPHONE:
(951) 682-7282
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY: 140TOTAL ENROLLED CHILDREN: 140CENSUS: 69DATE:
08/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Trudy Oliver TIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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
A case management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 08/14/24. It indicates a child sustained a scratch to their forehead during outside activity.
Facility records were reviewed, and pertinent party interviews were conducted, including 5 staff. Based on information gathered, the facility acted appropriately, and no violations have been identified. Facility reported timely; provided supervision; and notified authorized representatives. Facility completed reporting requirements and submitted an Unusual Incident Report (UIR) as required per CCR Title 22 Division 12 regulations.
An exit interview was conducted, and a copy of this report, appeal rights and notice of site visit were provided to facility representatives, Trudy Oliver and Tanya Soleski.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2024
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 1