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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215054
Report Date: 10/21/2025
Date Signed: 10/21/2025 11:43:26 AM

Document Has Been Signed on 10/21/2025 11:43 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:TEMPLE ETZ CHAIM PRESCHOOLFACILITY NUMBER:
566215054
ADMINISTRATOR/
DIRECTOR:		DEBBIE BLUMENTHALFACILITY TYPE:
830
ADDRESS:1080 E. JANSS ROADTELEPHONE:
(805) 497-6852
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 0DATE:
10/21/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:54 AM
MET WITH:Debbie Blumenthal and Keri LoventhalTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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On October 21, 2025 at 11 AM an office meeting was held at the Santa Barbara Regional Office for the purpose of having an informal conference with Director Debbie Blumenthal and Assistant Director Keri Loventhal. Present at the meeting was Licensing Program Manager (LPM) Susana Martinez, Licensing Program Analyst (LPA) Brian Fung, Director Debbie Blumenthal and Assistant director Keri Loventhal. The purpose of this conference will be to review and discuss care and supervision of children in a licensed facility.
The following issues were discussed:

On 10/21/2025, facility license #566215054 was reviewed. On 10/21/2025

Prior to license review, the facility was cited the following deficiencies and incidents:

On, 1/7/24, 10/24/24, 9/23/24, and 9/10/24 four (4) Unusual incident reports were reported:
1. Lack of supervision

On 11/7/23 Two (2) Type A violation was cited:
1. Lack of supervision
2. Personal Rights

Continued on 809-C
NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Fung
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: TEMPLE ETZ CHAIM PRESCHOOL
FACILITY NUMBER: 566215054
VISIT DATE: 10/21/2025
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On 11/7/23 one (1) Type B violation was cited:
1. Reporting Requirements

On 9/10/24 one (1) Type A violation was cited:
1. Lack of Supervision

On 9/10/24 one (1) Type B Violation was cited:
1. Reporting requirements

On 6/13/24 one (1) unusual incident reported was reported:
1. Personal Rights

In response to these discussions, Licensee has agreed to the following:
1. Licensee shall ensure children are provided with safe and healthful environment.
2. Licensee shall ensure that Personal Rights of children will not be violated at any time when children are in care.
3. Licensee shall ensure that the Child Care business will be operated free of harmful, hurtful or dangerous acts.
4. Licensee shall ensure that children will be supervised at all times.
5. Licensee will obtain training on Supervising Children and Children’s Personal Rights.
6. Licensee shall adhere to the California Code of Regulations, Title 22, Division 12 at all times.
7. Increased unannounced visits to monitor compliance for two years to be conducted by CCLD.
8. Licensees shall submit a written statement indicating how they will maintain compliance with California Code of Regulations, Title 22, Division 12 at all times by 11/04/2025.

Continued on 809-C
NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Fung
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: TEMPLE ETZ CHAIM PRESCHOOL
FACILITY NUMBER: 566215054
VISIT DATE: 10/21/2025
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Licensee was informed that training videos are available on the Community Care Licensing website at www.ccld.ca.gov. Licensee was provided with TSP information/resources.

Licensee was provided with the website for training courses that might be beneficial (copy of available courses was provided to Licensee). http://www.smarthorizons.org/childcare/purchase/courses/California
Upon receipt of this report, licensees shall post and provide copies of this licensing report to parents/guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensees to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC809.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

An exit interview was conducted with Director Debbie Blumenthal and Keri Loventhal. A copy of this report and appeal rights given

NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Fung
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
LIC809 (FAS) - (06/04)
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