330900842-10-11-2024-09-CC-GSEA-DAALHU-20241022084654

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 330900842
Report Date: 10/11/2024
Date Signed: 10/11/2024 03:14:17 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/08/2024 and conducted by Evaluator Giselle Carbullido

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20241008163219

FACILITY NAME:	TEMPLE BETH EL CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	330900842
ADMINISTRATOR:	TRUDY OLIVER		FACILITY TYPE:	850
ADDRESS:	2675 CENTRAL AVENUE		TELEPHONE:	(951) 682-7282
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92506
CAPACITY:	140	CENSUS: 68	DATE:	10/11/2024
		UNANNOUNCED	TIME BEGAN:	02:06 PM
MET WITH:	Trudy Oilver		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not provide complete report to authorized representatives.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On the date and time listed above, Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to investigate regarding the above complaint received on 10/08/2024. LPA was granted entry by facility representative, Trudy Oliver. LPA discussed purpose of visit, took census, and toured the facility. LPA met with facility representative to further discuss the complaint allegations and deliver findings.
It was alleged facility did not provide complete reports, in which a Type A citation was issued, to authorized representatives. During the investigation, LPA interviewed pertinent parties and reviewed records.
Pertinent party interviews stated a copy of the LIC809D page with attached statement was given to parents for a citation issued on 09/19/2024; however, the complete report, LIC809 and LIC 809C pages, were not provided.
LPA reviewed facility records, children files and report dated 09/19/24. File reviews revealed not all parent notifications were completed for the citation issued during a visit on 09/19/2024. Facility used form LIC9224 which states ‘Copy of any licensing report that documents a Type A deficiency cited at this facility…’ for acknowledgement of receipt of licensing report.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 09-CC-20241008163219

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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 CENTER	FACILITY NUMBER: 330900842
	VISIT DATE: 10/11/2024

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
26
27
28
29
30
31
32

Facility records revealed one out of four pages was provided to authorized representatives.
Additionally, visit report dated 09/19/24 states: “…facility representative to provide a copy of this licensing report dated 09/19/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents, guardians for 12 months from the date of this report.’
Based on interviews conducted and documentation reviewed, the Department has determined the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED, per Health and Safety Code 1596.8595(c)(1) and California Code of Regulations, Title 22, Division 12.
See LIC9099D for deficiency cited.
Appeal rights issued and discussed with licensee and their signature on this form acknowledges receipt of these rights. An exit interview was conducted, a copy of this report and Notice of Site Visit was provided to facility representative, Trudy Oliver. THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS UPON REQUEST.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 09-CC-20241008163219

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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 CENTER	FACILITY NUMBER: 330900842
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/11/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/16/2024 Section Cited HSC 1596.8595(c)(1)	1 2 3 4 5 6 7	HSC:1596.8595(c)(1): A licensed child day care facility shall provide to the parents... of each child receiving services ... copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care .... This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Facility representatives will provide authorized representatives a complete report of visit conducted on 09/19/24, and send updated LIC9224 forms to the department for all children enrolled in preschool program by POC due date.
	8 9 10 11 12 13 14	Based on LPA’s record review and interviews conducted the facility did not comply with the section cited above in providing a complete licensing report from visit conducted on 09/19/24 to authorized representatives. This is a potential risk to the health and safety of children in care.	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: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3