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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300606
Report Date: 06/12/2023
Date Signed: 06/12/2023 10:36:30 AM

Document Has Been Signed on 06/12/2023 10:36 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHILDREN'S PARADISE-ASH STREETFACILITY NUMBER:
376300606
ADMINISTRATOR:GONZALEZ, ERICAFACILITY TYPE:
850
ADDRESS:120 N ASH STREETTELEPHONE:
(760) 407-8500
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 122TOTAL ENROLLED CHILDREN: 122CENSUS: 30DATE:
06/12/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ereica GonzalezTIME COMPLETED:
09:30 AM
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On June 12, 2023, Licensing Program Analyst (LPA) William Chancellor and Licensing Program Manager (LPM) Pauline Beschorner met with Children’s Paradise – Ash (CCC) Director (DIR) Erica Gonzalez to discuss an unusual incident that was not reported timely to Community Care Licensing (CCL). CCC was made aware of an allegation of a staff 1(S1) pulling the hair of a child to gain their attention on 5/26/2023. The CCC did not report the incident to CCL until 4/29/23. The facility is being cited for Title 22 Regulation Section 101212(d)(1)(C). An exit interview was conducted, and a copy of this report was provided to Director Erica Gonzalez. A notice of site visit was also provided and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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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