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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300425
Report Date: 01/24/2022
Date Signed: 01/24/2022 03:45:28 PM

Document Has Been Signed on 01/24/2022 03:45 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:LITTLE BEARS TENDER CAREFACILITY NUMBER:
376300425
ADMINISTRATOR:HADNOT, MARIBELFACILITY TYPE:
830
ADDRESS:1111 HIGHLAND DRIVETELEPHONE:
(760) 805-1073
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY: 16TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/24/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Maribel HadnotTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Joanne Domingo arrived at the facility to conduct a PreLicensing Plan of Correction (POC) visit. The initial prelicensing visit was conducted on 1/19/22. The following corrections were verified as completed on 1/24/22:

1. APPLICANT HAS INSTALLED PERIMETER FENCING AND GATE (LOCATED NEXT TO INFANT ROOM) AT LEAST 4 FEET TALL AND SECURE AT THE GROUND LEVEL AND STABLE AT THE TOP RAILING. THE FENCE MUST FULLY ENCLOSE THE PROPERTY AND MAKE IT INACCESSIBLE FROM THE PUBLIC.
2. APPLICANT HAS INSTALLED A NEW OUTDOOR PERIMETER FENCING LOCATED BETWEEN THE RESIDENTIAL HOME AND CENTER PLAYGROUND THAT IS SECURED AT GROUND LEVEL NEEDS TO BE SECURED AND THE TOP OF THE FENCE TO PREVENT THE FENCE FROM COLLAPSING.
3. APPLICANT TO HAS INSTALLED A MESH FENCING TO MAKE THE LEFT SIDE STAIRS LEADING TO THE PLAY AREA BELOW INACCESSIBLE DUE TO SAFETY HAZARDS.
4. APPLICANT HAS PURCHASED 3 INFANT POTTY TRAINING SEATS.
5. APPLICANT HAS PURCHASED A DIAPER CHANGING TABLE WITH APPROPRIATE PADDING AND PLACE IT WITHIN ARMS REACH OF A SINK.
6. WAIVER HAS BEEN APPROVED TO ROTATE 5 INFANTS AT A TIME DURING OUTSIDE PLAY.

FACILITY #376300425 CONTINUED ON LIC 809C
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Joanne Domingo
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2022
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: LITTLE BEARS TENDER CARE
FACILITY NUMBER: 376300425
VISIT DATE: 01/24/2022
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FACILITY #376300425 CONTINUED FROM LIC 809

In addition to the PreLicensing corrections listed above, the following items were also verified:
1. Infant classroom has ALL the required postings including the LIC 610 and facility sketches, Safe Sleep, and Car seat law posted at the entrance to the Infant classroom.
2. Infant: Individual labelled cubbies for the children enrolled, individual cribs and bedding are set up for each infant enrolled.
3. The Infants room should have individual labeled binders, folder and/or clipboards for each child that has their infant feeding schedule, diaper changing schedule and Infants Needs and Service plan readily accessible for parents and staff.
4. Infant food preparation area in the infants room is stocked with , diapers, baby formula, baby food and extra bottles. The refrigerator in the Infants room has individual labeled bins for each child’s bottles.
5. Children’s files were reviewed for completeness and include: Signed Admission Agreement, LIC 627, LIC 700, LIC 613A, LIC 995, Health History, Physicians Report, Immunizations, Tuberculosis, and Safe Sleep plan.

The application will be submitted for approval with a maximum capacity of 13. An exit interview was conducted and a copy of this report was provided to the applicant on this date.

A copy of this report must be made available to the public for 3 years.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Joanne Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2022
LIC809 (FAS) - (06/04)
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