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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570310353
Report Date: 12/14/2023
Date Signed: 12/14/2023 11:22:15 AM

Document Has Been Signed on 12/14/2023 11:22 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TENDER LEARNING CAREFACILITY NUMBER:
570310353
ADMINISTRATOR:HUDDLESON, SHIRLEY AFACILITY TYPE:
850
ADDRESS:1818 LAKE BLVDTELEPHONE:
(530) 756-5351
CITY:DAVIS,STATE: CAZIP CODE:
95616
CAPACITY: 83TOTAL ENROLLED CHILDREN: 83CENSUS: 12DATE:
12/14/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Shirley HuddlesonTIME COMPLETED:
11:35 AM
NARRATIVE
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On December 14, 2023, Licensing Program Analysts (LPA’s) Lauren Scott and Jennie Tedlos conducted a case management inspection at the facility. LPAs met with Director, Shirley Huddleson. At time of arrival LPA's observed 12 children and two staff.

Based on observation and review facility did not notify parents immediately of a an injury which was more serious than a minor cut or scratch which poses a potential health, safety or personal rights risk to persons in care.

Title 22 deficiencies have been cited on subsequent page, LIC 809D.

An exit interview was conducted, and a Plan of Correction was reviewed and developed with the Director, Shirley Huddleson. A copy of this report and appeal rights were discussed and left for Director. A Notice of Site Visit was posted by LPA’s and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2023
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 12/14/2023 11:22 AM - It Cannot Be Edited


Created By: Jennie Tedlos On 12/14/2023 at 10:40 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TENDER LEARNING CARE
FACILITY NUMBER: 570310353

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
01/12/2024
Section Cited
CCR
101226(a)

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101226 Health-Related Services(a)... licensee shall immediately notify the child's ...representative if the child...sustains an injury more serious than a minor cut or scratch...shall obtain instructions from...representative regarding action to be taken. This requirement was not met as
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Staff conduct a training on notifying parents immediately of serious injuries and documenting incidents. Meeting minutes will be submitted to LPA along with staff signatures through email.
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evidenced by: Based on observation and interview, the facility did not comply with the section above. A child's family was not immediately notified of a serious injury that happened at the facility which poses a potential health, safety, or personal rights risk to children in care.
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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:Karyn Guerra
LICENSING EVALUATOR NAME:Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2023


LIC809 (FAS) - (06/04)
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