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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701411
Report Date: 03/17/2025
Date Signed: 03/17/2025 10:19:03 AM

Document Has Been Signed on 03/17/2025 10:19 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:COZY CUBSFACILITY NUMBER:
376701411
ADMINISTRATOR/
DIRECTOR:		ELIZABETH HANNFACILITY TYPE:
830
ADDRESS:2291 MAIN STREETTELEPHONE:
(760) 787-0612
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
03/17/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:01 AM
MET WITH:Elizabeth HannTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
NARRATIVE
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On 3/17/2025 @ 10:00AM, Licensing Program Analysts (LPAs) Nancy Diaz and Jody Dye conducted an unannounced case management inspection. The purpose of this inspection is to deliver an amended report dated 3/14/2025. LPA is issuing a separate report to one deficiency (Type B).

Exit interview was conducted with Elizabeth Hann. LPA reviewed and provided a copy of this report. Appeal rights were also given. Notice of Site visit must be posted for 30 days.

CONTINUED ON LIC 809D.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2025
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 03/17/2025 10:19 AM - It Cannot Be Edited


Created By: Nancy Diaz On 03/17/2025 at 09:54 AM
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
FACILITY NUMBER: 376701411

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/11/2025
Section Cited
CCR
101212

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REPORTING REQUIREMENTS. Upon the occurrence, during the operation of the child care center of any of the events...Any unusual incident...


This requirement was not met as evidenced by:
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Ms. Hann stated that she will report to the department immediately when an unusual incident occur. She also stated that she will contact Duty Line if incidents are reportable or not.
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Based on interviews, it was determined that the facility did not have running water on 3/5/2025 and 3/6/2025. Facility closed on 3/5/2025, however the next day 3/6/2025, there was insufficient water pressure for handwashing or to flush the toilet.
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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: 03/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2025


LIC809 (FAS) - (06/04)
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