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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830481
Report Date: 02/01/2024
Date Signed: 02/01/2024 12:46:31 PM

Document Has Been Signed on 02/01/2024 12:46 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHILDRENS LIGHTHOUSE OF RIVERSIDE, CAFACILITY NUMBER:
334830481
ADMINISTRATOR:BONNIE ACOSTAFACILITY TYPE:
850
ADDRESS:19743 LURIN AVENUETELEPHONE:
(951) 653-6688
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY: 128TOTAL ENROLLED CHILDREN: 104CENSUS: 81DATE:
02/01/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Director Bonnie AcostaTIME COMPLETED:
12:55 PM
NARRATIVE
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On 02/01/2024 at 11:10 AM Licensing Program Analyst (LPA) Susan Brewer, conducted a Case Management Inspection, due to deficiencies found during another inspection. The LPA was greeted by Director Bonnie Acosta and granted entry to tour the facility. LPA took a census of children in care. The following was discussed:

101229(a)(1) Responsibility for Providing Care and Supervision:



On 01/24/2024, during a review of facility records, LPAs Susan Brewer and Giselle Carbullido, obtained documentation regarding an Incident involving a child left unattended by two supervising staff, until another staff discovered the child’s whereabouts. On 11/20/2023, the Director documented their observations of video footage which shows the preschool child entering the restroom at 11:07 AM and closing the door behind them, while staff were occupied with other preschool children and tasks. At 11:23 AM, another staff discovered the child unattended in the restroom with a broken lid to the toilet tank and informed the child’s assigned teachers. The incident documented does not indicate if the authorized representative of the child left unsupervised was notified of the incident. See LIC809D for Type A violation cited.

101212(d)(1)(C) Reporting Requirements:

In addition, it was determined that the agency director failed to report the incident regarding a Lack of Supervision that occurred on 11/20/2023, where a preschool child was left unsupervised for up to 6 minutes. See LIC809D Type B violations cited.

****** Continued on LIC809C ****
Kimberly WilliamsTELEPHONE:
Susan BrewerTELEPHONE:
DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHILDRENS LIGHTHOUSE OF RIVERSIDE, CA
FACILITY NUMBER: 334830481
VISIT DATE: 02/01/2024
NARRATIVE
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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons:
On 01/24/2024 during a review of facility records, LPAs Susan Brewer and Giselle Carbullido, obtained documentation regarding a preschool staff speaking to children in a negative tone. On 12/29/2023, the Director documented an incident regarding an authorized representative reporting their observation of a staff member speaking at a child in a negative tone during pick up. The documentation indicates staff did not deny the allegation and informed the authorized representative they don’t normally work with two-year-old children. The documentation regarding the incident of yelling was not reported to the licensing department. See LIC809D for Type B violation cited.

A Civil Penalty has been assessed during this inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

LPA Susan Brewer informed Director Bonnie Acosta that this report dated 02/01/2024 documents 101229(a)(1) Responsibility for Providing Care and Supervision, Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Susan Brewer, informed the Director Bonnie Acosta, to provide a copy of this licensing report dated 02/01/2024, 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. A signed Acknowledgement of Receipt of Licensing Report LIC 9224, or other written statement, must be placed in the child's file for verification.

A civil Penalty was issued.

The Director was provided with a copy of their appeal rights and their signature on this form acknowledges receipt of these rights.

An exit interview was conducted, a copy of this report was provided to the Director and a Notice of Site Visit was issued.

THIS REPORT MUST BE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THREE YEARS.

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE:
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE:
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 02/01/2024 12:46 PM - It Cannot Be Edited


Created By: Susan Brewer On 02/01/2024 at 09:11 AM
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: CHILDRENS LIGHTHOUSE OF RIVERSIDE, CA
FACILITY NUMBER: 334830481

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/02/2024
Section Cited

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101229(a)(1) Responsibility for Providing Care & Supervision (a)The licensee shall provide care & supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time...
This regulation was not met as evidenced by:
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Based on LPA record review & interviews conducted, it was determined that on 11/20/2023 a Lack of Supervision occured where a daycare child was left unattended for 6 minutes by staff assigned to supervise, which posed an immediate risk to the health & safety of children in care.
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and training curriculum to ensure the regulation is met. Per director, agree to submit the plan and training curriculum by 02/02/2024.
The licensee also agrees to submit the proof of staff participation in training on or before 02/19/2024, to the department by fax, mail or e-mail.

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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:Kimberly Williams
TELEPHONE:
LICENSING EVALUATOR NAME:Susan Brewer
TELEPHONE:
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/01/2024 12:46 PM - It Cannot Be Edited


Created By: Susan Brewer On 02/01/2024 at 09:20 AM
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: CHILDRENS LIGHTHOUSE OF RIVERSIDE, CA
FACILITY NUMBER: 334830481

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/05/2024
Section Cited

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101212(d)(1)(C) Reporting Requirements in part; (d) Upon the occurrence... (1)Events reported shall include the following: (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.
This regulation was not met as evidenced by:
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Based on LPA record review, the licensee failed to notify the department of reported incidents that occured during operation hours regarding Lack of Supervision & Personal Rights violations, regarding staff & children, which posed both immediate & potential risks to the health & safety of children in care.
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Type B
02/02/2024
Section Cited

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101223(a)(1) Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
This regulation was not met as evidenced by:
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Based on LPA record review & interviews conducted, it was determined that on 12/29/2023 an authorized representative reported witnessing a staff yelling at a preschool child in the classroom, upon pick up, which is a potential risk to the health & safety of children in care.
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Per director, they agree to submit the plan and training curriculum by 02/02/2024.
The licensee also agrees to submit the proof of staff participation in training on or before 02/19/2024, to the department by fax, mail or e-mail.
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:Kimberly Williams
TELEPHONE:
LICENSING EVALUATOR NAME:Susan Brewer
TELEPHONE:
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2024


LIC809 (FAS) - (06/04)
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