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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334808529
Report Date: 09/24/2021
Date Signed: 09/24/2021 04:21:12 PM

Document Has Been Signed on 09/24/2021 04:21 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
334808529
ADMINISTRATOR:ABBY LEWISFACILITY TYPE:
850
ADDRESS:27321 NICHOLAS ROADTELEPHONE:
(951) 693-4843
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY: 96TOTAL ENROLLED CHILDREN: 0CENSUS: 39DATE:
09/24/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:04 PM
MET WITH:Abby LewisTIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Ana Noble and Sumayya Habeebulla arrived at the facility on a follow up on a visit conducted on 2/24/2020, for a Case Management incident Unusual Incident/Injury Report, LIC624, which was reported on 2/11/2020 and took place on 2/11/2020. LPA Noble has returned to complete the investigation into the issue of a child being left behind. LPAs met with Ms. Abby Lewis, Director to discuss purpose of visit. LPA toured and took census with Mr. Jaime Flores.

LPA informed Ms. Lewis that a visit had been conducted last year on 2/24/2020, however due to the Staff #1, who was involved not being present at that on 2/24/2020, LPA extended the investigation into the matter. During todays visit, Ms. Lewis informed LPA Noble that, Staff #1, had been terminated shortly after the date of incident. LPA Noble reviewed files. LPA will return at a later date to obtain additional information.

At this time, LPA will be extending the investigation regarding this incident to obtain additional information.

An exit interview was held with Ms. Lewis, Director. A Notice of Site visit was issued, along with a copy of this report. A copy of this report must be made available upon request to the public for 3 years.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2021
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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