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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841268
Report Date: 09/30/2024
Date Signed: 09/30/2024 03:14:44 PM

Document Has Been Signed on 09/30/2024 03:14 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:TEMPLE LEARNING CENTERFACILITY NUMBER:
364841268
ADMINISTRATOR/
DIRECTOR:		DAVIS, LINDAFACILITY TYPE:
850
ADDRESS:1583 UNION STREETTELEPHONE:
(909) 885-4695
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92411
CAPACITY: 30TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
09/30/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:02 PM
MET WITH:Linda DavisTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 09/30/2024 Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the Facility for another purpose. LPA met with Facility Director, Linda Davis and discussed the following.

The purpose of this visit was to observe corrections for deficiencies cited on 08/10/2023, from the previous year's unannounced annual visit. The following deficiencies have been cleared by visit:

101238(a) Buildings and Grounds:
Facility was previously cited for a non functioning restroom. The subject facility bathroom was observed to be safe, sanitary and functional. LPA observed a functioning toilet, sink, and light within the back restroom.

101161(a) Limitations on Capacity and Ambulatory Status
Facility was previously cited for allowing a school age child to attend during operating hours. LPA did not observe any school age children present during today's unannounced visit.

101174(d) Disaster and Mass Casualty Plan
Facility was previously cited for not documenting a fire/disaster drills. LPA reviewed fire/disaster drill log and found the facility to be in compliance since the previous deficiency was cited.

101238.2(d) Outdoor Activity Space
Facility was previously cited for the surface of outdoor place space in disrepair. LPA observed the outdoor play space to be clean, free of weeds and rubbish with sufficient wood chips under climbing/play structure.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TEMPLE LEARNING CENTER
FACILITY NUMBER: 364841268
VISIT DATE: 09/30/2024
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101220(a) Child's Medical Assessments
Facility was previously cited for missing medical assessments within children's records reviewed. LPA reviewed a sample of five children's records which all contained medical assessments. Of the missing documents mentioned previously, the facility either collected the required documentation, or the child was no longer enrolled at the facility.

101220.1(g) Immunizations
Facility was previously cited for missing immunization records within children's records reviewed. LPA reviewed a sample of five children's records which all contained immunization records. Of the missing documents mentioned previously, the facility either collected the required documentation, or the child was no longer enrolled at the facility.

101221(b)(8)(C) Child's Records
Facility was previously cited for missing LIC627 consent for emergency medical treatment documents, within children's records reviewed. LPA reviewed a sample of five children's records which all contained LIC627. Of the missing documents mentioned previously, the facility either collected the required documentation, or the child was no longer enrolled at the facility.

101229.1(a)(1) Sign In and Sign Out
Facility was previously cited for sign in/sign out logs missing signatures from authorized representatives of children in care. LPA reviewed current sign in/sign out records and observed them to meed requirements.

1596.841 Current roster of children provided care in facility required.
Facility was previous cited for not completing a required roster of children in care. LPA observed updated and current roster.

LPA documented proof of corrections with photographs, observations and records reviewed. LPA discussed corrections and provided Facility Director, Linda Davis with Proof of Correction letters and a copy of this report.

An exit interview was conducted and this report was reviewed with Facility Director, Linda Davis.
A Notice of Site Visit was issued and must remain posted in a prominent location within the facility for the next 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024
LIC809 (FAS) - (06/04)
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