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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817886
Report Date: 11/29/2022
Date Signed: 11/29/2022 10:22:44 AM

Document Has Been Signed on 11/29/2022 10:22 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:TUTOR TIME CHILD CARE/LEARNING CENTERFACILITY NUMBER:
364817886
ADMINISTRATOR:MYRNA ARELLANOFACILITY TYPE:
850
ADDRESS:7390 ELLENA WESTTELEPHONE:
(909) 948-8311
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 47DATE:
11/29/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Melissa Rodriguez/Assistant DirectorTIME COMPLETED:
10:50 AM
NARRATIVE
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On 11/29/22 at 9:03 am, Licensing Program Analyst (LPA) Patricia Berry conducted a case management-deficiencies investigation regarding Unusual Incident that occurred on 11/18/22. LPA was granted access into the facility and met with Melissa Rodriguez/assistant director. LPA toured facility and took a census.

It was self- reported at nap time a child left the classroom unseen and was found a few minutes later in another classroom, alone. According to staff the child was on the mat resting in the classroom as the teacher was preparing the other children for nap on the other side of the classroom. The teacher noticed the child was not on the child’s mat. Staff stated the changing table obstructed the teachers view of all the children. Staff stated she alerted the director and staff started looking for the child. Staff stated the child was found alone, in another classroom.

According to regulation: 101229 Responsibility for Providing Care and Supervision (1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation.



See 809D for deficiency

Civil penalty LIC 421IM assessed today for $500.00.

Exit interview conducted with assistant director, report, appeal rights, Notice of Site Visit, and Acknowledgement of Receipt provided to assistant.

Notice of Site Visit must be posted for 30 days along with the 809 report.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 11/29/2022 10:22 AM - It Cannot Be Edited


Created By: Patricia Berry On 11/29/2022 at 07:34 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: TUTOR TIME CHILD CARE/LEARNING CENTER
FACILITY NUMBER: 364817886

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/29/2022
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision (a)...provide care and supervision ...(1) No child(ren) shall be left without the supervision...Supervision shall include visual observation.
This requirement was not met as evidenced by
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On 11/18/2022, Director immediately called "Code Adam" meaning a child is missing from the classroom. Director changed where the children would sleep so the teacher has a better view of all the children.
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Based on facility self-reporting a child went missing from the classroom.

This is an immediate risk to the health and safety of children in care.
Civil Penalty LIC 421IM assessed today.
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 Director stated she will have a staff training on supervision by 12/2/2022. Director stated she will send the topic and a list of participants to CCL by 12/2/2022.

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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:Gilbert Sena
LICENSING EVALUATOR NAME:Patricia Berry
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2022


LIC809 (FAS) - (06/04)
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