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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817886
Report Date: 08/12/2022
Date Signed: 08/12/2022 11:56:23 AM

Document Has Been Signed on 08/12/2022 11:56 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: 39DATE:
08/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Myrna Arellano/directorTIME COMPLETED:
12:30 PM
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On 8/12/2022 at 8:45 am, Licensing Program Analyst (LPA) Patricia Berry conducted a subsequent case management incident investigation for two Unusual Incident Reports (UIRs). LPA was granted access into the facility and met with the director. LPA toured facility and took a census.

Regarding the first incident on 7/20/2022, a child dislocated elbow. It was self-reported by director staff was going to have a group activity, freeze dance. Director stated staff asked the children to go to the circle area. Director stated two children went to the book area instead. Director stated staff was helping both children up by holding their hands, as one child sat back down quickly causing a jerking motion in the arm.

Regarding the second incident that occurred on 7/27/2022 a child dislocated shoulder, It was self-reported by director, staff asked the children to go to the table for snack. Director stated staff helped one child sit on the chair by guiding child underneath child’s arms.

Both incidents resulted in the children diagnosed with Nurse-Maid Elbow. Director stated she was not made aware the children had Nurse-Maid Elbow prior to the incidents occurring.

After conducting interviews and reviewing documentation, LPA has determined there has been no violation of Title 22 regulations at this time. The director has had a training for all staff on other ways to handle children.



Exit interview conducted with director, report, appeal right 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: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2022
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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