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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334820648
Report Date: 08/06/2024
Date Signed: 08/06/2024 09:57:18 AM

Document Has Been Signed on 08/06/2024 09:57 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 SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MURRIETA VALLEY USD/TOVASHAL ELEMENTARYFACILITY NUMBER:
334820648
ADMINISTRATOR/
DIRECTOR:		KATHLEEN ISRAELSENFACILITY TYPE:
850
ADDRESS:23801 ST. RAPHAELTELEPHONE:
(951) 696-2183
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
08/06/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Kathleen IsraelsenTIME VISIT/
INSPECTION COMPLETED:
10:05 AM
NARRATIVE
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On August 8, 2024 at 09:15 AM Licensing Program Analyst (LPA) Courtnee Peebles conducted an unannounced case management visit to conduct an inspection for a classroom change request. LPA met with Kathleen Israelsen, Program Director. Upon arrival LPA was informed Room four is currently licensed and they will be moving to room 8 for their preschool program. However room eight is not currently licensed. LPA informed the program director that an application and facility sketch will be needed as well as a fire clearance. Once all documents and fire clearance is received LPA will return to conduct a case management vist for a room change. The days and hours of operation will remain the same: Monday through Friday 07:00 AM to 3:30 PM
.
No deficiencies were cited.

An exit interview was conducted with Kathleen Israelsen. A copy of this report was provided.



This report must be made available at the facility for 3 years for public review upon request
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
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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