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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376105207
Report Date: 01/28/2026
Date Signed: 01/28/2026 02:51:55 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2025 and conducted by Evaluator Renita Rodriguez
COMPLAINT CONTROL NUMBER: 51-CC-20251104115728
FACILITY NAME:TEMPLE ADAT SHALOMFACILITY NUMBER:
376105207
ADMINISTRATOR:MARILYN MILNEFACILITY TYPE:
860
ADDRESS:15905 POMERADO ROADTELEPHONE:
(858) 451-1200
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:83CENSUS: 38DATE:
01/28/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Marilyn MilneTIME COMPLETED:
03:08 PM
ALLEGATION(S):
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Staff are not following reporting requirements.
INVESTIGATION FINDINGS:
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On 1/28/26 at 12:30 p.m.. Licensing Program Analyst (LPA) Renita Rodriguez made an unannounced complaint visit for the complaint received on 11/04/25. The purpose of this visit is to deliver findings on the above reference allegation. LPA was granted entry after identifying self, showing badge, and disclosing the reason for the visit. LPA met with Director Marilyn Milne. Ratios observed 38 children and 6 staff.


It was alleged that staff are not following reporting requirements. Information obtained from interviews and review of pertinent documentation showed that an unusual incident occurred in March 2025 that had not been reported to the Department nor to the parent of the child involved, per Title 22 regulation. Staff protocols and procedures for reporting incidents include an email and/or phone call to the Department within 24 hours and to the parent, either immediately via the Bright Wheel app or by the end of the day in person. The urgency of the reporting is determined by the Director or Assistant Director.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 51-CC-20251104115728
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: TEMPLE ADAT SHALOM
FACILITY NUMBER: 376105207
VISIT DATE: 01/28/2026
NARRATIVE
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The allegation is valid because the preponderance of the evidence has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12, Chapter number 1) the deficiency is being cited on the attached LIC 9099D. The Notice of Site Visit was provided, and LPA observed posting. Director is advised it must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Marilyn Milne.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2025 and conducted by Evaluator Renita Rodriguez
COMPLAINT CONTROL NUMBER: 51-CC-20251104115728

FACILITY NAME:TEMPLE ADAT SHALOMFACILITY NUMBER:
376105207
ADMINISTRATOR:MARILYN MILNEFACILITY TYPE:
860
ADDRESS:15905 POMERADO ROADTELEPHONE:
(858) 451-1200
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:83CENSUS: DATE:
01/28/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:TIME COMPLETED:
03:08 PM
ALLEGATION(S):
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Staff handled child inappropriately while in care.
INVESTIGATION FINDINGS:
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On 1/28/26 at 12:30 p.m.. Licensing Program Analyst (LPA) Renita Rodriguez made an unannounced complaint visit for the complaint received on 11/04/25. The purpose of this visit is to deliver findings on the above reference allegation. LPA was granted entry after identifying self, showing badge, and disclosing the reason for the visit. LPA met with Director Marilyn Milne. Ratios observed 38 children and 6 staff.

It was alleged that staff handled child inappropriately while in care. During observation, LPA did not observe any child being handled inappropriately. Information obtained from staff and parent interviews was inconclusive and there were no similar concerns expressed. No documentation was provided to support the incident and there were no direct witnesses.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 51-CC-20251104115728
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: TEMPLE ADAT SHALOM
FACILITY NUMBER: 376105207
VISIT DATE: 01/28/2026
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the above allegation is found to be Unsubstantiated. Exit interview conducted and report was reviewed with the Director Marilyn Milne. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 51-CC-20251104115728
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: TEMPLE ADAT SHALOM
FACILITY NUMBER: 376105207
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/10/2026
Section Cited
CCR
101212(d)(1)
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101212 Reporting Requirements(d) Upon occurrence, during operation of child care center any of events specified in(d)(1), report shall be made to Depart. by phone or fax within next working day and normal business hours. In addition, written report shall be submitted to the dept within 7
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Director states meeting will be held with staff on 1/28/26 regarding unusual incidents as deemed reported by title 22 regulations as well as activities in regulations. The incident is sent to parents and responsible parties on bright wheel in the incidents section.
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This requirement is not met as evidenced by:Based on interview and record review, the faclity did not report an unusual incident which poses a potential Health, Safety or Personal Rights risks to persons in care.

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The classrooms and staff utilize the tablets to communicate to parents regarding any incidents that occurred with a child in care. Director will sent the sign in sheet with signatures of all staff in attendance.
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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.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5