Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370568
Report Date: 12/22/2015
Date Signed: 12/22/2015 02:54:20 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:COLLEEN'S CUDDLE BUGS CHILD CAREFACILITY NUMBER:
304370568
ADMINISTRATOR:DURAN, COLLEENFACILITY TYPE:
830
ADDRESS:2100 EAST LAMBERT ROADTELEPHONE:
(562) 266-1300
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:10CENSUS: 4DATE:
12/22/2015
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Stefanie JamarilloTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA), Rina Lopez conducted a Plan of Correction visit due to deficiencies cited on 12/08/15. LPA was allowed entrance into the facility by Stefanie Jamarillo. LPA and Ms. Jamarillo toured the infant area to ensure that the facility was complying with plan of correction received 12/09/15 in which it was stated that the infant children were going to be supervised while napping and at all times. Children's cots were also moved into the napping area.

Upon entering the infant room, LPA observed 2 staff in the infant napping area with 4 infants. LPA observed one staff carrying an awake infant into the activity area for infant to be changed. Based on LPA's observation, both deficiencies are cleared per today's visit.

It was required that facility post the Facility Evaluation Report (LIC 809) documenting Type A deficiency, facility is also required to post this document verifying your compliance with the Department's order to correct a Type A deficiency. This letter must be posted immediately upon receipt and remain posted for 30 consecutive days.

Exit interview conducted with facility representative, Stefanie Jamarillo. Notice of Site Visit posted by LPA.
SUPERVISOR'S NAME: Marian WallmeierTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Rina LopezTELEPHONE: (714) 703-2824
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2015
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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