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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330900842
Report Date: 10/26/2023
Date Signed: 10/26/2023 03:00:18 PM

Document Has Been Signed on 10/26/2023 03:00 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:TEMPLE BETH EL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
330900842
ADMINISTRATOR:TRUDY OLIVERFACILITY TYPE:
850
ADDRESS:2675 CENTRAL AVENUETELEPHONE:
(951) 682-7282
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY: 140TOTAL ENROLLED CHILDREN: 140CENSUS: 59DATE:
10/26/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Trudy Oliver, Administrative DirectorTIME COMPLETED:
02:45 PM
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Due to lead testing requirements, Licensing Program Analysts(LPAs), Giselle Carbullido and Perla Ordones conducted a Case Management inspection based on lead testing results received on the facility. LPAs Carbullido and Ordones toured the facility, took census, and met with Administrative Director, Trudy Oliver and Associate Director, Tanya Soleski to discuss lead testing results and measures taken for remediation of lead exceedances.
During the inspection, LPAs toured and obtained photos of the following water outlets identified with lead exceedances: Outlet D (7.5 ppb) located in room 4; Outlet G (8.5 ppb) located outdoors preschool playground; Outlet M (5.9 ppb) located in room 10; Outlet O (7.7 ppb) located in room 11; Outlet T (25 ppb) located outdoors; Outlet V ( 7.1 ppb) located in room 14; Outlet W (8.9 ppb) located in room 15; Outlet Z (8.8 ppb) located in room 16 and Outlet F (5.5 ppb) located in the kitchen. Facility implemented the following plan of action for remediation or removal of water outlets: Required signage posted at outlets for cessation of use for outlets F, G, T and W and permanent removal of outlets: M, O, V, and Z. Outlet D tested in error and not used for drinking or food preparation.
LPAs observed notification of lead results posted at the facility: Front entry gate. LPAs observed facility has access to additional water resources: faucets and sports jugs.

Due to facility water outlets testing above approved lead levels, a deficiency has been cited. See LIC809D.



The following resources were discussed and provided from PIN 21-21.1-CCP dated December 28, 2022: which includes information on: 101700.6 Grant Funding for Qualifying Child care Centers and instructions for remediation.
An exit interview was conducted, and appeal rights discussed. LPAs Carbullido and Ordones provided Administrative Director, Trudy Oliver with a copy of this report, appeal rights and notice of site visit. This report must be made available to the public upon request for three years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2023
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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Document Has Been Signed on 10/26/2023 03:00 PM - It Cannot Be Edited


Created By: Giselle Carbullido On 10/26/2023 at 02:30 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 10/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/27/2023
Section Cited
CCR
101700.3(b)(2):

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California Lead Action Level at Child Care Centers 101700.3 (b)(2): Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care. This requirement is not met as evidence by:
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Facility will implement corrective action pursuant to section CCR 101704 for immediate cessation of outlets testing with action level exceedance until it is replaced and retested pursuant to section CCR 101705 and returns a result at or below the Acton level. Facility will notify CDSS with completion within 30 days.
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Based on records review of required lead testing, the facility had lead values of 5 or above on water outlets: D,F, G, M,O,T, V, W and Z This is a potential health and safety risk to persons in care.
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Facility will notify CDSS with completion within 30 days.

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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
LICENSING EVALUATOR NAME:Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2023


LIC809 (FAS) - (06/04)
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