<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846845
Report Date: 01/21/2026
Date Signed: 01/21/2026 04:54:27 PM

Document Has Been Signed on 01/21/2026 04:54 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:TENDER CARE FOR KIDSFACILITY NUMBER:
364846845
ADMINISTRATOR/
DIRECTOR:
WEBB,CARMENFACILITY TYPE:
860
ADDRESS:525 N DEARBORN STREETTELEPHONE:
(909) 793-4885
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY: 121TOTAL ENROLLED CHILDREN: 68CENSUS: 42DATE:
01/21/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Carmen Webb Director (facility representative)TIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On the above noted date and time, Licensing Program Analyst's (LPA's), Diana Brasel and Griselda Castellon conducted an announced Pre-Licensing inspection to add a toddler option component. Currently the facility has an infant, preschool and school-age components. Upon completion of adding the toddler option component the facility will become a single license with four components. Current facility numbers are 364816955 (infant), 364816953 (preschool), 364816954 (school-age), upon completion of making the facility a single license the current three licenses will be closed as a single license conversion. Upon arrival, LPA met with Facility Representative (director) Carmen Webb. The licensee is requesting (20) infants ages 6 weeks - 24 months, (20) toddler option children ages 18 months - 36 months, (41) preschool children ages 24 months - Kindergarten, and (40) school-age children ages Kindergarten - 12 years.
Hours of operation will be Monday - Friday 6:00 am - 6:30 pm.
An updated LIC 200A was requested on today's visit to reflect the needed change for the requested toddler option capacity due to indoor measurements for room 4.
Infants will be (20) children, toddler option will be (13), preschool will be (41) and school-age will be (40) children, total requested capacity will 114.
Fire clearance was granted on 09/09/25.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 10
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Facility will provide lunch, am and pm snacks. The kitchen area currently includes, sink, stove/oven, dishwasher, freezer, refrigerator, microwave, and toaster, The kitchen area and food storage areas were observed free of rodents and/or vermin. Food was observed to be properly stored separate from cleaning materials. Hazardous items in kitchen are inaccessible to children via a locked door.

All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Carmen Webb that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. When medications are on site, Carmen stated that they will be in a higher cabinet located in the office. When medications need to be refrigerated they will be kept in the infant room 10 inside a locked box. A fully equipped first aid kit is located in the office and all classrooms have an emergency backpack. There is an operational carbon monoxide detector on site located in each classroom. All required licensing documents were observed posted in the lobby. Children will be signed in and out in the lobby.

LPA continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space measured 705.46 for infants, measured 470.51 for toddler option children, measured 1463.22 for preschool children, and measured 1953.54 for school-age children. An updated LIC 200A will be needed to reflect the needed change for the requested capacity of toddler option children due to the measurements taken of the toddler option room 4 during today's visit.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 3 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping mats, bookshelves, and other activity supplies for the children. Drinking water is available in the classrooms via drinking fountain and personal water bottles. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property.

LPA's observed a total of (1) sink, two changing tables with an adult sink located within arms reach of both changing tables, the director stated, they will purchase a potty chair for infants use (see correction needed) and an additional potty chair when needed to be in compliance with the one potty chair for every five infants. An additional children's sink will be needed for the infant room to accommodate the requested capacity. LPA's observed a total of (1) sink, (1) toilet, (1) changing table for toddler option children


(an adult sink will be needed-see correction needed). LPA's observed a total of (3) sinks and (3) toilets for pre-school children. LPA's observed a total of (4) sinks and (4) toilets for school-age children. There are sufficient sinks and toilets to accommodate the requested capacity's for toddler option, preschool, and school-age children. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be the office.

The facility currently has a fully fenced playground area. Fencing is a combination of wrought iron and a block wall, that is at least four feet high. The total square footage for the outdoor activity space is 3227.00 for infants, 1967.00 for toddler option children, 3406.80 preschool children, and 9204.60 for school-age children. All outdoor measurements are sufficient to accommodate the requested capacity's for all components. ----continued on LIC 809C----
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 10 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Shade is provided via a canopy and building overhang on the infant playground, the toddler option playground has a large tree and building overhang, the preschool playground has building overhang (additional shade shall be installed - (see correction needed), the school-age playground 2 has a two large trees and building overhang, school-age playground 1 has building overhang (additional shade shall be installed - (see correction needed). There are sufficient outdoor age-appropriate toys and play equipment available on the playground. There is an age appropriate climbing structure on the preschool playground and the school-age playground 2, which are properly anchored. There is adequate cushioning in fall zones of climber located on the preschool playground and the school-age playground 2 provided by sand. Drinking water is available via pitchers with personal water bottles and school age playground has a drinking fountain and there is a second drinking fountain located between the staff restroom. LPA observed all hazardous items on the playground to be inaccessible to children. Facility representative was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

High chairs and feeding tables have broad-based legs, plastic seats are in good repair and trays lock on to chairs. High chairs are made of washable, moisture-resistant material. Changing tables have at least 1” padding covered with moisture-resistant, washable material. Sides of the changing table are at least 3” high. Diapering sink is not used for meal preparation or dishwashing. Cribs meet regulatory requirements. Crib area is separated from activity space via a separate room located within the infant room. LPA discussed with the facility representative/director that direct supervision is required at all times when a child is sleeping in the napping room in a crib.

---continued on LIC 809C----

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 4 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Sleep logs are kept in the napping room and the Needs and Services Plans and Sleep Plans are kept in the infant room. The facility representative/director stated, they will purchase a potty chair (see correction needed) and an additional potty chair when needed to be in compliance with the one potty chair for every five infants.

Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

This facility plans to provide Incidental Medical Services - currently no children enrolled are in need of IMS– IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.



LPA reviewed with facility representative the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 5 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Facility representative was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Subscribe to CCLD important information - Child Care Centers and Family Child Care Homes:
“Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.”

Safe Sleep (for infant centers)– Child Care Centers and Family Child Care Homes: The facility currently has an infant component and will be adding a toddler option component.
LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 6 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Lead Testing- CCC Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCC's) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test as specified in Health and Safety Code section 1597.16.

LPA verified that the lead testing was completed in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. Last test was conducted on 01/27/2024.

The following corrections are needed prior to the issuance of the single license:


Infant:
1. Proof that at least one potty chair for infants has been purchased, shall be submitted.
2. Proof that an additional children's sink has been purchased and installed to meet
Title 22 regulations of 1 sink for every 15 children, shall be submitted.
3. The red mat located in the infant room that is not in good repairs shall be replaced or
removed, proof shall be submitted.
4. Proof that the chipped/broken area with exposed compressed wood of the counter top
located by the changing table has been repaired, shall be submitted.
5. Proof that all crib mattress not in good repair have been replaced, shall be submitted.

Toddler option:
1. Proof that and adult sink has been installed within arms reach of the changing table,
shall be submitted.

----continued on LIC 809C---
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 7 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
2. Proof that some type of gate has been installed in the entrance way to prevent access
to the preschool room, shall be submitted. The rooms shares one door to access
both the toddler option and preschool rooms.
3. Proof that a retractable gate has been added in the outside walkway for the toddler
option children to access their outdoor playground, shall be submitted.
4. Proof that an additional table and chairs have been added to accommodate requested
capacity, shall be submitted.

Pre-school:
1. Proof that some type of gate has been installed in the entrance way to prevent access
to the toddler option room, shall be submitted. The rooms share one door to access
both the preschool and toddler option rooms.

School-age:
1. Proof that the chipped/broken areas with exposed compressed wood of the children's
sink counter tops located in all 4 rooms has been repaired, shall be submitted.


All component classrooms and or outdoor playground:
1. Proof that all ceiling panels in all classrooms with water stains or damage have been
replaced, shall be submitted.
2. Proof that all children's toy wooden cabinets in all classrooms that have exposed
compressed wood have been either removed, repaired or replaced, shall be submitted. 3. Proof that all outdoor wrought iron fencing located on all outdoor playgrounds that have
rust or broken sharp areas has been repaired or replaced, shall be submitted.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 8 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TENDER CARE FOR KIDS
FACILITY NUMBER: 364846845
VISIT DATE: 01/21/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
4. Proof that the wrought iron area / chain link gate on the school-age playground 2 has
been repaired, shall be submitted. The repair shall be at least four feet tall and prevent
access to the large off limit area located beyond the enclosed fenced playground 2.
5. Proof that the wrought iron fence separating the school-age playground 2 and the
preschool playground shall be 4 feet tall all the way across, proof shall be submitted.
6. Proof that the wooden post for the bar structure located on the school-age playground
two that has chipped paint has been repaired, shall be submitted.
7. Proof that the wrought iron fence located on the toddler option playground which
provides access to the parking lot shall be reinforced so that the gate closes flush,
shall be submitted.
8. Proof of repairs to the window screen on the preschool classroom located off of the
preschool playground, shall be submitted.

The remaining requested missing documents for the pending application shall be submitted prior to completing the single license conversion.

Exit interview conducted and report was reviewed with the facility representative, Carmen Webb.

Facility representative Carmen Webb understands that all proof of corrections must be provided to the Department within 30 days, or the request to add the additional component may be denied.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Diana Brasel
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC809 (FAS) - (06/04)
Page: 9 of 10