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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364816953
Report Date: 08/08/2019
Date Signed: 08/08/2019 02:32:17 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:TENDER CARE FOR KIDSFACILITY NUMBER:
364816953
ADMINISTRATOR:CARMEN WEBBFACILITY TYPE:
850
ADDRESS:525 NORTH DEARBORN STREETTELEPHONE:
(909) 793-4885
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY:61CENSUS: 33DATE:
08/08/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Carmen WebbTIME COMPLETED:
02:45 PM
NARRATIVE
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On 8/8/19, Licensing Program Analyst (LPA) Destinee Hogue conducted an inspection at the facility. LPA met with Director Carmen Webb and Athula Siriwardena, toured the facility, took census and verified staff's criminal record clearances and association to facility. It was found during this inspection that a criminal record transfer request for staff supervising children are not associated to the facility.

See LIC809D for deficiency cited per California Code of Regulations Title 22, Division 12.

An exit interview was conducted with Director Carmen Webb and Athula Siriwardena, appeal rights discussed, and a Notice of Site Visit was issued and must be posted for 30 days. THE NOTICE OF SITE VISIT IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS ALONG WITH A COPY OF THE TYPE A DEFICIENCY (LIC809D) CITED DURING THIS VISIT. A COPY OF THE TYPE A DEFICIENCY CITED DURING THIS VISIT MUST ALSO BE IMMEDIATELY (within 24 hours of the child’s next day in care) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364816953
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/08/2019
Section Cited
CCR
101170(e)(2)
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101170 Criminal Record Clearance. (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance.
This requirement was not met as evidenced by:
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During inspection 8/8/19, Director Carmen Webb submitted a criminal record transfer request for Staff #1. Deficiency cleared during this inspection.
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Based on LPA tour of facility and interview with staff, it was found that the Licensee failed to submit a criminal record transfer request for Staff #1. This poses an immediate health, safety and personal rights risk to children in care.
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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: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
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