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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 06:28:30 PM

Document Has Been Signed on 08/05/2024 06:28 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 - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Barbara Leerskov and Virginia AndradeTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 8/5/2024, at 2:45pm, Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection to site for deficiencies observed during another inspection at the facility. LPA met with teacher Barbara Leerskov and discussed the purpose of the inspection. LPA accompanied by teacher Barbara Leerskov was led on a tour of the facility. There were 40 children present with four (4) staff. LPA observed seven (7) napping children and three (3) children who were awake and off of their napping mats in the Preschool 3 classroom with Staff #1(S1) who meets the qualification of an aide. LPA observed 13 children in the Toddler Room (age 18 – 36 months) with eight (8) napping children and five (5) children who were awake and sitting at the table eating snack alone with Staff #2 (S2) who meets the qualification of an aide.

At 3:15pm, Director, Maria Morales from Cozy Cubs 3 arrived to the facility. At 3:30pm, Director, Virginia Andrade arrived at the facility. Directors immediately step into the classrooms to provide coverage. During the time of inspection, LPA reviewed staff files.

Based on observation and interview, one (1) Type A and one (1) Type B deficiencies of California Code of Regulations, Title 22, Division 12, Chapter 1, are being cited on the attached LIC 809D.

LPA informed Director, Virginia Andrade that this report dated 8/5/2024 documents one (1) Type A citation, which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA informed Director to provide a copy of this licensing report dated 8/5/2024 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. LPA provided Virginia Andrade with form LIC 9224. See LIC 809C Continuation...
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 - PRESCHOOL
FACILITY NUMBER: 376701519
VISIT DATE: 08/05/2024
NARRATIVE
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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
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/05/2024 06:28 PM - It Cannot Be Edited


Created By: Vicky Williamson On 08/05/2024 at 05:06 PM
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 2 - PRESCHOOL
FACILITY NUMBER: 376701519

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/19/2024
Section Cited
HSC
1596.955(a)(3)

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1596.955 Child day care centers serving preschool age children; optional program; departmental guidelines and regulations (3)A ratio of six children to each teacher is maintained for all children in attendance at the toddler program... This requirement is not met as evidenced by:
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Upon arrival to the facility Director, Maria Morales immediatley provided coverage in the classroom. Director, Virginia Andrade stated that she will conduct a training regarding staffing ratios and submit summary of the training, staff sign in sheets and a plan of action on how the staff will maintain
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Based on observation and interview, the licensee did not comply with the section cited above in that LPA observed in the Toddler Room 13 children, 5 of whom were eating snack and 8 napping with one aide, which poses an immediate health, safety or personal rights risk to persons in care.
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a 1:6 ratio in the Toddler Room. Director stated that she will submit the documents no later than 8/19/2024.

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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:Tulam Vu
LICENSING EVALUATOR NAME:Vicky Williamson
LICENSING EVALUATOR SIGNATURE:
DATE: 08/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/05/2024


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Document Has Been Signed on 08/05/2024 06:28 PM - It Cannot Be Edited


Created By: Vicky Williamson On 08/05/2024 at 05:29 PM
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 2 - PRESCHOOL
FACILITY NUMBER: 376701519

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/05/2024
Section Cited
CCR
101216.2(e)

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101216.2 Teacher Aide Qualifications and Duties (e) An aide shall work only under the direct supervision of a teacher.
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Deficiency cleared during time of inspection. The Directors, Maria Morales and Virginia Andrade immediately step into the Preschool 3 and Toddler Room to provide coverage.
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Based on observation, interview and record review, the licensee did not comply with the section cited above in that LPA observed S1 and S2 who are aides, alone in the classrooms which poses a potential health, safety or personal rights risk to persons 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:Tulam Vu
LICENSING EVALUATOR NAME:Vicky Williamson
LICENSING EVALUATOR SIGNATURE:
DATE: 08/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/05/2024


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