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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483004700
Report Date: 06/06/2019
Date Signed: 06/06/2019 03:22:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:TUTOR TIME LEARNING CENTER-INFANTFACILITY NUMBER:
483004700
ADMINISTRATOR:WRIGHT, ALICIAFACILITY TYPE:
830
ADDRESS:3345 CHERRY HILLS COURTTELEPHONE:
(707) 422-4105
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:32CENSUS: 16DATE:
06/06/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Alicia WrightTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Ouye arrived to conduct a case management visit regarding an incident for child C1 which occurred on 6/3/19. At 8:50am staff S1 noticed orange object in the mouth of child C1. Staff removed the object which turned out to be a capsule of medication.
Staff called administration for assistance. The management kept the remaining portion of the capsule and gave it to the parent to take to the hosptial. Parent was called. Prior to the parent arriving at the center, C1 was observed and did not have appear to have any physical affect.
Parent took C1 to local emergency room along with the remainder of medication. The hospital identified the medication and sent the child home with parent.

Staff did a sweep of the rooms to see if any other medication was present in the facility. No other medication was found. The Director sent out an email notification to all parents making them aware of the situation to be cautious when bringing children to the center to have any medication in their possession in sealed containers to prevent a future incident.

The Director spoke with the parent of C1 later that day and the child was fine. The child returned to the center the following day.

No deficiency issued during the visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019
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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