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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600145
Report Date: 08/15/2022
Date Signed: 08/15/2022 04:20:54 PM


Document Has Been Signed on 08/15/2022 04:20 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:ALEXA'S PLAYCFACILITY NUMBER:
376600145
ADMINISTRATOR:NORA CAMACHOFACILITY TYPE:
850
ADDRESS:3685 KEARNY VILLA ROADTELEPHONE:
(858) 966-8555
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:92CENSUS: 58DATE:
08/15/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nora CamachoTIME COMPLETED:
01:45 PM
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On 8/15/22 at 12:45 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced Proof of Corrections (POC) visit at the facility. Upon arrival LPA Lane met with facility representative Director Nora Camacho and toured the facility. Census was 58 children in 5 rooms with 20 staff members. LPA Lane observed appropriate capacity and ratio while at the facility. The reason for the visit is to follow up on staff training required due to Type A citation on 8/5/22 when five children accidentally ingested uncooked chicken in the Walrus room on 7/21/22.

LPA received proof of staff training via e-mail on 8/8/22, however it wasn’t clear that those who prepare the food received the proper training information. LPA interviewed staff and Director while at the facility. LPA obtained information during that visit, that all staff preparing food received training handouts. Staff member responsible for preparing food will also receive additional training and complete a food handler certificate.

LPA toured the kitchen area where food is prepared. LPA observed clean kitchen area, no expired foods and food in freezer was listed as fully cooked.

Based upon LPA’s observations and interviews with staff it was found that all staff received the required training handouts and are aware of proper preparation/serving of food to the children. No additional deficiencies cited at this time. Type A deficiency has been cleared.

Exit interview conducted and report was reviewed with facility representative Director Nora Camacho. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2022
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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