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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701378
Report Date: 10/01/2024
Date Signed: 10/01/2024 01:36:11 PM

Document Has Been Signed on 10/01/2024 01:36 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:COZY CUBS INC.FACILITY NUMBER:
376701378
ADMINISTRATOR/
DIRECTOR:		ELIZABETH HANNFACILITY TYPE:
850
ADDRESS:2291 MAIN STREETTELEPHONE:
(760) 787-0612
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY: 78TOTAL ENROLLED CHILDREN: 78CENSUS: 55DATE:
10/01/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:Annette Kurtenbach & Elizabeth HannTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On 10/1/2024, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced case management inspection. A tour of the facility was conducted. The following census were observed at 9:05AM:
  • Toddler group with 10 children and staff Tanya Campbell-Rice (FQT) & Jasmine Sanchez (Aide)
  • Teddy Bears with 12 children and staff Amy Clark (Teacher), Juliana Rangel (Aide) & Alyssa Weichert (Aide)
  • Polar Bears with 15 children and staff Halee Brown (FQT), Brianna Burrus (Aide) & Riyen Chapp (Aide)
  • Grizzlies with 18 children Dayane Valdivia (FQT) & Alexa Garcia (Aide with no units).

Type B deficiency was cited today. Type B deficiency if not corrected poses a potential risk to the health, safety or personal rights of children in care.

Exit interview was conducted with Annette Kurtenbach. LPA reviewed and provided a copy of this report with Ms. Kurtenbach. Appeal rights and notice of site visits were also given. Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2024
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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Document Has Been Signed on 10/01/2024 01:36 PM - It Cannot Be Edited


Created By: Nancy Diaz On 10/01/2024 at 12:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: COZY CUBS INC.
FACILITY NUMBER: 376701378

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/08/2024
Section Cited
CCR
101216.3(b)(1)

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TEACHER-CHILD RATIO.
A ratio of one fully qualified teacher (as specified in Section 101216.1(c)) and one aide for every 18 children in attendance...allowed when the aide meets the qualifications specified in Section 101216.2(d).
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This was corrected today. Temporary correction was to move 3 youngest in the group to the Teddy Bears room.
A fully qualified teacher and an aide (with 6 units) will be placed in the Grizzlies room.
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This requirement was not met as evidenced by:
Based on record review and Ms. Kurtenbach's statement, the Aide in the Grizzlies did not meet the requirement for section 101216.2(d), she only has 3 units completed.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Joelle Redding
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 10/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2024


LIC809 (FAS) - (06/04)
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