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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846084
Report Date: 02/21/2025
Date Signed: 02/21/2025 03:27:43 PM

Document Has Been Signed on 02/21/2025 03:27 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:EVERBROOK ACADEMYFACILITY NUMBER:
334846084
ADMINISTRATOR/
DIRECTOR:		TAMMIE RENFROFACILITY TYPE:
840
ADDRESS:14276 SCHLEISMAN ROADTELEPHONE:
(951) 272-8700
CITY:EASTVALESTATE: CAZIP CODE:
92880
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 7DATE:
02/21/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Tammie Renfro, DirectorTIME VISIT/
INSPECTION COMPLETED:
03:32 PM
NARRATIVE
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Licensing Program Analyst (LPA) Elyse Jones arrived at the facility to conduct a Case Management inspection for the purpose of addressing separate matters that were discovered during an unsubstantiated complaint inspection at the facility. During the inspection LPA conducted a tour of the facility and census were taken. Although the complaint resulted in unsubstantiated allegations alleging that staff did not intervene in the physical altercation, the LPA was provided information of a child sustaining an injury while in care. It was disclosed Child #1 took the shoe of Child #2, Child #2 punched, scratched, and attempted to bite Child #1. In response, Child #1 grabbed Child #2 hair and pulled out a significant amount. Pertinent parties confirmed there was staff present and the incident was observed, however, the altercation was over by the time staff could reach the children.

See LIC 809-D for deficiency cited



A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Tammie Renfro, Director.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 02/21/2025 03:27 PM - It Cannot Be Edited


Created By: Elyse Jones On 02/21/2025 at 02:18 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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: EVERBROOK ACADEMY
FACILITY NUMBER: 334846084

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
02/24/2025
Section Cited
CCR
101223(a)(3)

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The licensee shall ensure that each child is accorded the following personal rights:
(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to:..
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another child.
Based on the observation, interview, record review, the Licensee did not meet the above regulation which poses an immediate Health, Safety & Personal Rights risk to the children in care. During the course of an investigation
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Based on the observation, interview, record review, the Licensee did not meet the above regulation which poses an immediate Health, Safety & Personal Rights risk to the children in care. During the course of an investigation the LPA was provided documentation of a child being injured during an altercation with
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the LPA was provided documentation of a child being injured during an altercation with another child.

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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:Aaron Ross
LICENSING EVALUATOR NAME:Elyse Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2025


LIC809 (FAS) - (06/04)
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