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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372000597
Report Date: 03/12/2024
Date Signed: 03/12/2024 11:08:22 AM

Document Has Been Signed on 03/12/2024 11:08 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:TRI-CITY CHRISTIAN PRE-SCHOOLFACILITY NUMBER:
372000597
ADMINISTRATOR:LAURA KATIE DONAHUEFACILITY TYPE:
850
ADDRESS:302 NORTH EMERALD DRIVETELEPHONE:
(760) 630-8227
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY: 111TOTAL ENROLLED CHILDREN: 111CENSUS: 79DATE:
03/12/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Katie Donahue, DirectorTIME COMPLETED:
11:30 AM
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On date and time listed, Licensing Program Analyst (LPA) William Chancellor and Licensing Program Manager (LPM) Pauline Beschorner arrived unannounced to the facility to conduct a case management visit due to an unusual incident report (UIR) received on 03/06/2024. The incident involved a child climbing on a playground slide, slipping and fracturing their wrist. LPA met with Director (DIR) Katie Donahue and conducted a tour of the facility. Appropriate ratio's and supervision was observed.

During the visit, LPA conducted interviews with two staff (S1-S2) and one parent. (P1) Interviews revealed that the incident occurred during extended care and staff were in ratio at the time of the incident. LPA has determined that the facility staff acted appropriately, notified the parents and C1 was given appropriate medical attention in a timely manner. Additionally, Director Donahue notified CCL and submitted a UIR in a timely manner.

Based on the information gathered, there appears to be no violations of Title 22 Regulations found at this time, and therefore, there were no deficiencies cited during this inspection.

An exit interview was conducted, a copy of this report, LIC 811 (Confidential Names List) and appeal rights were reviewed with and provided to Director Katie Donahue. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2024
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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