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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701519
Report Date: 08/05/2024
Date Signed: 08/05/2024 06:29:43 PM

Document Has Been Signed on 08/05/2024 06:29 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:COZY CUBS 2 - PRESCHOOLFACILITY NUMBER:
376701519
ADMINISTRATOR/
DIRECTOR:		VIRGINIA ANDRADEFACILITY TYPE:
850
ADDRESS:4351 PARKS AVETELEPHONE:
(619) 460-6432
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY: 51TOTAL ENROLLED CHILDREN: 52CENSUS: 40DATE:
08/05/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:31 PM
MET WITH:Barbara Leerskov and Virgina AndradeTIME VISIT/
INSPECTION COMPLETED:
06:15 PM
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On 8/5/2024, at 4:31pm, Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection regarding a self - reported incident. LPA met with Director, Virginia Andrade and discussed the purpose of the inspection. LPA accompanied by teacher Barbara Leerskov was led on a tour of the facility and playground. There were 40 children with four (4) staff, 12 of the children present are ages 18 – 36 months.

On 7/1/2024, the director self- reported an incident involving Child #1 (C1). Per Director, the incident occurred on 6/26/2024 at approximately 4:35pm.

Interviews were conducted with the director and C1. LPA obtained related documentation and reviewed files for C1 and staff. This incident requires further investigation.

An exit interview was conducted with Director, Virginia Andrade, and a copy of this report, and Appeal Rights were provided. Notice of Site Visit was provided and is required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LPA observed Notice of Site Visit posted on the bulletin board at the entrance.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE: DATE: 08/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2024
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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