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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376619795
Report Date: 05/24/2022
Date Signed: 05/24/2022 02:34:42 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/23/2022 and conducted by Evaluator Nancy Diaz
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20220523144940
FACILITY NAME:DELA CRUZ, EDEN FAMILY CHILD CAREFACILITY NUMBER:
376619795
ADMINISTRATOR:EDEN DELA CRUZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 566-9342
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:14CENSUS: 9DATE:
05/24/2022
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Eden Dela CruzTIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Licensee did not notify daycare child's representative of child's condition.
INVESTIGATION FINDINGS:
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On 5/24/2022 @ 12:45PM, LPA Nancy Diaz conducted an unannounced inspection in reference to the above allegation. LPA met with Eden Dela Cruz, Licensee. Observed present today were 9 children (4 of which were under age 2 y.o.). Licensee's spouse, Domingo Dela Cruz was also present. Chilren's Records were reviewed. Mrs. Dela Cruz stated that she will fax a copy of the children's roster to LPA at (619) 767-2203. According to Mrs. Dela Cruz, she noticed the child having a temperature between 4:00 to 4:30pm. She admitted her failure to notify the parent of the child's high temperature. The preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated, California Code of Regulations, (Title 22, 102416.2(f) is being cited on the attached LIC 9099D.). Appeal Rights (1/16) were discussed and provided. Notice of Site Visit was posted during this visit and will remain posted for 30 days.
Exit interview was conducted with Mrs. Dela Cruz. A copy of this report and appeal rights were provided today. Notice of site visit was provided and observed posted today.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 51-CC-20220523144940
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: DELA CRUZ, EDEN FAMILY CHILD CARE
FACILITY NUMBER: 376619795
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2022
Section Cited
CCR
102416.2(f)
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OPERATION OF A FAMILY CHILD CARE HOME. As soon as possible but no later then the same business day, the licensee shall notify a child's parent or authorized representative regardless of the injuries or acts that affect that child ...

This requirement was not met as evidenced by
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Mrs. Dela Cruz stated that she will contact the parents immediately after a child is found to have a temperature or exhibiting signs of illness. She will put this in writing and submit a copy to the Department no later than end of business of 5/25/2022.
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Based on licensee's statement, she failed to notify the child's parent when child was observed to have a temperature between 4:00 - 4:30PM.
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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: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2