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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817886
Report Date: 01/20/2022
Date Signed: 01/20/2022 11:50:53 AM

Document Has Been Signed on 01/20/2022 11:50 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: 42DATE:
01/20/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Myrna Arellano/DirectorTIME COMPLETED:
12:16 PM
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On 1/20/2022 at 11:00 am, Licensing Program Analyst (LPA), conducted a case management incident investigation regarding an Unusual Incident Report reported on 12/22/21. It was reported a child fractured her arm, while sliding down the slide. It was reported the child was on the top of the slide, getting ready to slide down and another child came and held the child's arm while playing a game called "save me".


Due to additional information needed, LPA will return at a later date to deliver the final report.




Exit interview conducted with director Myrna Allellano., report, appeal rights and notice of site visit provided to director.


This report must be made available for three yers.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/20/2022
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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