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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376621410
Report Date: 08/14/2019
Date Signed: 08/27/2019 10:31:56 AM



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
07/15/2019 and conducted by Evaluator Adrian Castellon
COMPLAINT CONTROL NUMBER: 20-CC-20190715115358
FACILITY NAME:PEREZ, ALEJANDRA FAMILY CHILD CAREFACILITY NUMBER:
376621410
ADMINISTRATOR:ALEJANDRA PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 475-2862
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY:14CENSUS: DATE:
08/14/2019
UNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Alejandra PerezTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Facility operated over capacity
INVESTIGATION FINDINGS:
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LPA Adrian Castellon conducted a complaint investigation on this date. LPA Castellon met with licensee Vazquez and discussed the purpose of the inspection. Facility is within ratio and capacity on this date.

On 07.15.19, the SDCCRO received a complaint report alleging that the Perez, Alejandra Family Child Care was operating over capacity while providing care on 07.12.19. LPA Castellon interviewed licensee Perez during the course of the investigation. LPA Castellon obtained reports pertaining to the allegation. Based on information provided by the reporting party and the licensee's own admission, the preponderance of the evidence standard has been met, therefore the above allegation, that the facility was over capacity when staff provided care for 15 children when a large license allows for 14 children max, is found to be Substantiated and is being cited on the attached LIC 9099D. The licensee was provided a copy of the Appeal Rights and their signature on this form acknowledges receipt of these rights.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019
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 20-CC-20190715115358
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: PEREZ, ALEJANDRA FAMILY CHILD CARE
FACILITY NUMBER: 376621410
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/14/2019
Section Cited
CCR
102416.5(f)
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102416.5 Staffing Ratio and Capacity:

(f) The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.
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Licensee Perez states that she will speak to the daycare parents about arriving on time to pick up children. Licensee Perez states that this incident stemmed from unforseeable circumstances.
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This requirement was not met as evidenced by reporting party's report and licensee's own admission that the facility provided care for 15 children were present for approximately 15-45 minutes on 07.12.19. This poses a potential health and safety threat to clients 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: Joe CarrascoTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2