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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701521
Report Date: 06/21/2022
Date Signed: 06/25/2022 03:05:43 PM

Document Has Been Signed on 06/25/2022 03:05 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:COZY CUBS 3 - PRESCHOOLFACILITY NUMBER:
376701521
ADMINISTRATOR:TUOHY DUNNFACILITY TYPE:
850
ADDRESS:8475 LA MESA BLVDTELEPHONE:
(858) 243-9287
CITY:LA MESASTATE: CAZIP CODE:
91942
CAPACITY: 28TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/21/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Annette KurtenbachTIME COMPLETED:
02:45 PM
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On 6/21/2022 at 12:15pm, Licensing Program Analyst (LPA), Martha Malane arrived at the facility to conduct a pre-licensing inspection. LPA met with Applicant, Annette Kurtenbach and facility representative Elizabeth Hann and proceeded to tour the facility. Applicant is requesting a capacity of 28 preschool children (age 2 – 5 years) in rooms C & D. Applicant’s planned hours of operation are Monday - Friday 6:00am to 6:00pm.

The indoor space measured a total of 1036.23 square feet which is sufficient to accommodate 29 children, however applicant is only requesting a capacity of 28 children. Classrooms are equipped with age appropriate furniture and equipment including tables, cots for napping, chairs, cubbies, bookshelves and other materials for children. There are four (4) toilets and six (6) sinks available for use which is sufficient to accommodate the requested capacity. Drinking water is available outdoors and indoors via water jugs and disposable cups. There is a separate restroom for staff located next to the office. The staff restroom is equipped with one (1) toilet and one (1) sink and will be utilized as an isolation restroom for children who are ill. The Director's office will be utilized for the isolation area if a child becomes ill. Disinfectants and cleaning solutions are kept in an inaccessible cabinet in the staff restroom.

The kitchen area includes one (1) sink, one (1) refrigerator with a freezer, one (1) microwave and storage space. The facility utilizes Brightwheel for sign in/out. Required documents are posted. There is an operational carbon monoxide detector and first aid kit which meet requirements.

The outdoor activity space was inspected and measured a total of 2355.99 square feet which is sufficient to accommodate 31 children, however applicant is only requesting a capacity of 28. The outdoor space is fenced and shade is provided by the use of a tree. Proper supervision and placement of staff outside was discussed to ensure the safety of children at all times.

Continued See LIC809C…
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: COZY CUBS 3 - PRESCHOOL
FACILITY NUMBER: 376701521
VISIT DATE: 06/21/2022
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Incidental Medical Services (IMS) was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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)/ (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 and Applicant discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Applicant 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA reviewed and provided applicant with PIN 22-06-CCP regarding lead testing in child care centers and PUB 515 regarding lead exposure.

A Fire clearance for 28 preschool children (age 2 – 5 years) was granted 5/17/2022.

An exit interview was conducted with Applicant, Annette Kurtenbach. A license may be granted after a final file review.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
LIC809 (FAS) - (06/04)
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