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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334841842
Report Date: 11/03/2022
Date Signed: 11/04/2022 09:42:27 AM

Document Has Been Signed on 11/04/2022 09:42 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:KIDDIE ACADEMY OF MURRIETAFACILITY NUMBER:
334841842
ADMINISTRATOR:ELIZABETH SRONCE HOLMESFACILITY TYPE:
850
ADDRESS:41755 JUNIPER STREETTELEPHONE:
(951) 600-0545
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY: 108TOTAL ENROLLED CHILDREN: 82CENSUS: 59DATE:
11/03/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Sarah LiebfreidTIME COMPLETED:
02:35 PM
NARRATIVE
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Licensing Program Analyst (LPA) James Wilkerson arrived at this facility to conduct a case management visit in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 10/27/22. It indicates that a staff member had walked out of a classroom where 12 children who were napping, leaving them unattended for less than one minute. Based on information received from staff interview, the 12 children being left unattended for any amount of time, there will be a citation issued for a lack of supervision due to this incident.

See LIC809D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12.
Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility for the next 12 months.

The Notice of Site Visit and Type A Deficiencies from today’s visit must be posted for 30 days. Failure to keep these posted for the entire 30 days will result in an immediate $100 civil penalty for each.

An exit interview was conducted, appeal rights discussed and provided along with a Notice of Site Visit, form LIC 9224 (AB 633) and a copy of this report on this date.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: James Wilkerson
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2022
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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Document Has Been Signed on 11/04/2022 09:42 AM - It Cannot Be Edited


Created By: James Wilkerson On 11/02/2022 at 02:48 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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KIDDIE ACADEMY OF MURRIETA
FACILITY NUMBER: 334841842

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/03/2022
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision - (a) The licensee shall provide care and 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, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Staff member who left the 12 napping children unattended has been terminated from employment at this facility.
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This requirement was not met as evidenced by the admission of staff that a teacher left 12 napping children unattended inside a classroom for less than one minute. This poses an immediate risk to the health and safety of the children.

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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:Carlos Martinez
LICENSING EVALUATOR NAME:James Wilkerson
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022


LIC809 (FAS) - (06/04)
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