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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830367
Report Date: 03/28/2024
Date Signed: 03/28/2024 01:08:12 PM

Document Has Been Signed on 03/28/2024 01:08 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:SCHOOL TIME CHILDREN'S LEARNING CENTERFACILITY NUMBER:
334830367
ADMINISTRATOR:BRIANA CHAVEZFACILITY TYPE:
840
ADDRESS:4655 TEXAS AVENUETELEPHONE:
(951) 785-9001
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY: 17TOTAL ENROLLED CHILDREN: 17CENSUS: 9DATE:
03/28/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Gayani WedanarachchiTIME COMPLETED:
01:20 PM
NARRATIVE
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On 03/28/24, Licensing Program Analyst Giselle Carbullido arrived for another purpose. Upon arrival, the Assistant Director greeted LPA Carbullido and granted permission to enter the facility and toured the premises with LPA. At 8:06 AM, LPA observed 9 school age with 10 pre- school children engaged in table activities within the school age program.

Please see LIC 809D for deficiency cited.

Exit interview conducted and report was reviewed with the Director, Gayani Wedanarachchi.



A notice of site visit and appeal rights were given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2024
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 03/28/2024 01:08 PM - It Cannot Be Edited


Created By: Giselle Carbullido On 03/28/2024 at 12:04 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: SCHOOL TIME CHILDREN'S LEARNING CENTER
FACILITY NUMBER: 334830367

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/28/2024
Section Cited
CCR
101538.3(b)

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101538.3Indoor Activity Space for School-Age Childre . In combination programs, indoor activity space provided for school-age child care center children shall be physically separated from space provided for infant care and child care center children. This requirement is not met as evidence by:
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Cleared during visit, preschool and school age children were separated into their respective programs.
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Based on LPA observation upon arrival school age was comingling with preschool children past the first hour allowed and no transition was in progress until LPA pointed out conditions of waiver on file. This is a potential health, safety or personal rights risk to persons in care.
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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: 03/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2024


LIC809 (FAS) - (06/04)
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