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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701378
Report Date: 03/11/2025
Date Signed: 03/11/2025 01:43:02 PM

Document Has Been Signed on 03/11/2025 01:43 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: 69DATE:
03/11/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:01 PM
MET WITH:Elizabeth HannTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
NARRATIVE
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On 3/11/2025, Licensing Program Analyst (LPA) conducted an unannounced inspection. A tour of the facility was conducted with Elizabeth Hann, Site Director. At approximately 11:40, LPA observed 2 children in the bathroom (next to the Teddy Bears) without visual supervision. Staff was observed at the other end of the room to grab lunch for one of the children.

California Code of Regulations, (Title 22, Division 12, Chapter number) the deficienciy is being cited on the attached LIC 809D.

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. Licensing report was reviewed and provided today. Appeal rights were also given. Notice of site visit was provided. This notice shall remain posted for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
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 03/11/2025 01:43 PM - It Cannot Be Edited


Created By: Nancy Diaz On 03/11/2025 at 01:15 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: 03/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/11/2025
Section Cited
CCR
101229(a)(1)

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RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION.
No child(ren) shall be left without the supervision of a teacher at any time...

This requirement was not met as evidenced by:
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Ms. Hann stated that she will meet with staff individually. She will submit a statement from staff acknowledging training no later than 3/14/2025.
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Based on observation, LPA observed 2 children without visual supervision in the bathroom. Supervising teacher was observed on the other side of the classroom.
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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: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2025


LIC809 (FAS) - (06/04)
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