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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817886
Report Date: 08/02/2022
Date Signed: 08/02/2022 03:15:56 PM

Document Has Been Signed on 08/02/2022 03:15 PM - 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: 46DATE:
08/02/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Myrna Arellano/DirectorTIME COMPLETED:
03:40 PM
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On 8/2/2022 at 2:15 pm, Licensing Program Analyst (LPA) Patricia Berry conducted a case management-incident report regarding an incident that occurred on 7/20/2022 . LPA was granted access into the facility. LPA toured facility and took a census. LPA interviewed children.


It was self-reported by director the teacher was guiding the children to another area of the classroom to the dancing area. Director stated two children were sitting down and the teacher went to help them stand by holding both children's hands, and one child stood up and the other child buckled down and would not move and in doing so the child's elbow became dislocated. Director stated the teacher notified the director because the child started to cry and noticed the child was holding her arm, so director immediately went to the classroom, called the parents and they took the child to Urgent Care. Director stated the parent's stated child was diagnosed with Nurse-Maid Elbow. Director stated she was not made aware the child had Nurse-Maid Elbow prior to the incident occurring.

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


Exit interview with the director, appeal rights and notice of site visit issued.

Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2022
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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