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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300426
Report Date: 01/24/2022
Date Signed: 01/24/2022 03:49:14 PM

Document Has Been Signed on 01/24/2022 03:49 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:
376300426
ADMINISTRATOR:HADNOT, MARIBELFACILITY TYPE:
840
ADDRESS:1111 HIGHLAND DRIVETELEPHONE:
(760) 805-1073
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/24/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME 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 INSTALLED TWO TETHER BALL FIXTURES IN THE OUTDOOR PLAY AREA.
5. APPLICANT WAS REMINDED TO UTILIZE THE STACKED CHAIRS IN THE CHAPEL TO ENCLOSE THE CHAPEL PULPIT AND MAKE IT INACCESSIBLE TO SCHOOL AGE CHILDREN WHEN THE CLASSROOM IS IN USE.
6. PLAYGROUND WAIVER APPROVAL TO SHARE PLAYGROUND WITH PRESCHOOL PROGRAM IS POSTED.

FACILITY #376300426 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)
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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: 376300426
VISIT DATE: 01/24/2022
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FACILITY #376300426 CONTINUED FROM LIC 809

In addition to the PreLicensing corrections listed above, the following items were also verified:
1. School Age classroom has ALL the required postings including the LIC 610 and facility sketches posted at the entrance to the School Age classroom.
2. The kitchen is stocked with food and snacks at least a two weeks supply. Paper goods and disposable goods should also be available.
3. Applicant understands that Children’s files must include: Signed Admission Agreement, LIC 627, LIC 700, LIC 613A, LIC 995, Health History, Physicians Report, Immunizations, Tuberculosis.

The application will be submitted for approval with a maximum capacity of 14. 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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