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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334812347
Report Date: 04/19/2022
Date Signed: 04/19/2022 11:30:01 AM

Document Has Been Signed on 04/19/2022 11:30 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:RCOE-PERRIS HEAD START STATE PRESCHOOL EARLY HEADFACILITY NUMBER:
334812347
ADMINISTRATOR:JILL WILSONFACILITY TYPE:
850
ADDRESS:148 AVOCADO AVENUETELEPHONE:
(951) 826-7200
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 165TOTAL ENROLLED CHILDREN: 116CENSUS: 70DATE:
04/19/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Lori WiedensohlerTIME COMPLETED:
11:40 AM
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On the date and time listed, Licensing Program Analysts (LPAs) Sumayya Habeebulla and Nasha King at the facility to conduct a Case Management-Incident follow-up visit on an Unusual Incident Report (UIR) received by the Department on 03/30/2022. LPAs met with Lori Wiedensohler (Director) to discuss the incident. A tour of the facility was granted, and census was conducted.

On 03/10/2022, it was reported that a Contract staff member who is a mental Health Clinician had handled a child roughly. Ms. Wiedensohler and staff reported to Child Protective services (CPS) and the Mental Health Coordinator. The staff member involved in the incident was removed from the facility immediately and is not allowed to return to the facility. There was no follow up made by CPS.

LPAs have determined that the facility took the necessary steps to ensure the health and safety of the children in care by removing the staff member from the classroom/facility, and reporting the incident to the Department (Community Care Licensing).

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, and a copy of this report was provided to Lori Wiedensohler (Director). A Notice of Site Visit was issued and the Licensee understands that it must remain posted for 30 days.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE: DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/19/2022
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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