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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830481
Report Date: 04/05/2023
Date Signed: 04/05/2023 12:36:52 PM

Document Has Been Signed on 04/05/2023 12:36 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: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: 128CENSUS: DATE:
04/05/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Bonnie Acosta, Center DIrectorTIME COMPLETED:
12:45 PM
NARRATIVE
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On April 5, 2023, Licensing Program Analyst (LPA) Kay Turner arrived at the facility on a case management visit to follow-up on an unusual incident report submitted by the facility on April 3, 2023. At the time of visit, LPA toured the facility, including the location where the incident took place, and took census. LPA observed classroom was 9 out of ratio as there was 1 staff member to 15 children.

LPA met with Center Director, Bonnie Acosta, to discuss the reported incident. LPA ascertained a child received an ouchie report on 03/27/2023 leading up to the unusual incident report. During the visit, LPA also spoke with the teachers who witnessed the incident as it took place. The subject child involved in the incident was not interviewed by the LPA as the child no longer attends the facility.

Based on the information obtained during the visit, the facility was out of ratio on the day of the ouchie report, which is a violation of Title 22 Regulations.

An exit interview was held with Center Director, Bonnie Acosta. A Notice of Site visit was issued. Appeals rights were provided along with a copy of this report.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2023
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 04/05/2023 12:36 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Karrene Turner On 04/05/2023 at 12:01 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: CHILDRENS LIGHTHOUSE OF RIVERSIDE, CA
FACILITY NUMBER: 334830481

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
04/06/2023
Section Cited
CCR
101216.3(a)

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Teacher-Child Ratio:
There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance,....

This requirement was not met as evidenced by:
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The Director agrees to submit an updated LIC 500 to ensure the facility is in compliance with the ratio requirements. In addition, the licensees agreee to provide a memo of understanding to acknowledge the seriousness of complaince with teacher-child ratio.
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Based on staff interviews, on 03/27/2023 classroom 6 was out of ratio as there was 1 staff to 14 children. On 04/05/2023, LPA observed classroom 9 out of ratio as there was 1 staff to 15 children. This poses 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:Aaron Ross
LICENSING EVALUATOR NAME:Karrene Turner
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2023


LIC809 (FAS) - (06/04)
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