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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334808529
Report Date: 02/22/2023
Date Signed: 02/22/2023 03:19:10 PM

Document Has Been Signed on 02/22/2023 03:19 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: 120CENSUS: 80DATE:
02/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Abbey LewisTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPAs) Sumayya Habeebulla and Jeanette Sanchez made an unannounced visit to the facility for another purpose.

On 02/13/23 LPA Habeebulla had emailed and requested Facility Director for the results of the retesting that the facility had conducted. LPA had not received it prior to the arrival at the facility. During the visit LPA requested for the documents and Ms. Lewis forwarded LIC 9275 and an email stating that the preliminary results have no exceedances of lead in water. The same email also states that this is just a preliminary result and not the final findings. LPAs requested the Facility Director to submit the following documents to the department by 03/08/23 -

1. LIC 9275

2. LIC 9276

3. Facility Sketch indicating the location of all tested faucets.

4. First report of the Lead Testing

5. Retest Report of Lead Testing

LPAs also advised Facility Director to post the reports and notify parents at the facility of the testing and retest.

An Exit Interview was conducted, A Notice of Site visit was given, and the Facility Representative understands that it must remain posted for 30 days.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2023
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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