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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842336
Report Date: 11/06/2023
Date Signed: 11/06/2023 02:07:16 PM

Document Has Been Signed on 11/06/2023 02:07 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHILDREN'S LIGHTHOUSE LEARNING CENTERFACILITY NUMBER:
334842336
ADMINISTRATOR:LINDA SCOTTFACILITY TYPE:
830
ADDRESS:23656 CLINTON KEITH ROADTELEPHONE:
(951) 600-9395
CITY:MURRIETASTATE: CAZIP CODE:
92562
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 10DATE:
11/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Linda ScottTIME COMPLETED:
02:15 PM
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On November 6, 2023, at 01:25 PM Licensing Program Analyst (LPA) Courtnee Peebles arrived unannounced to the facility to conduct a case management visit due to an unusual incident report submitted for an incident that occurred on 10/10/2023 involving a child (C1) sustaining an injury. C1 was placed into a high chair when S1 began to remove C1 by removing the high chairs table and turned around to put the tray down when C1 leaned forward and fell out of the high chair. Parents picked C1 up immediately and took C1 to the emergency room where C1 was observed. Parents were informed to continue to watch C1 and ensure C1's motors skills to ensure they are still active. LPA met with Director (D) Linda Scott and conducted a tour of the facility. LPA observed the area where the incident occurred and conducted interviews with D, who was present when the incident occurred. LPA determined that the facility was not in violation of licensing regulations and acted appropriately. There were no deficiencies issued during this visit. An exit interview was conducted, a copy of this report, provided to Director Linda Scott. A Notice of Site Visit was also provided and shall remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2023
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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