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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376626229
Report Date: 03/02/2022
Date Signed: 03/02/2022 02:52:24 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
02/28/2022 and conducted by Evaluator Nancy Diaz
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20220228132449
FACILITY NAME:RIVERA, KARINA FAMILY CHILD CAREFACILITY NUMBER:
376626229
ADMINISTRATOR:KARINA RIVERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 208-6141
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY:14CENSUS: 6DATE:
03/02/2022
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Karina RiveraTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility is not free from condition which might endanger a child.
INVESTIGATION FINDINGS:
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On 3/2/22 @ 1:45PM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced inspection. LPA met and toured the facility with Karina Rivera, Licensee. Observed present today were 6 children (2 were under age 2). Four children were oberved napping in the master bedroom and bedroom #3. Helper Yaribel Valdez was also present. Intern Jazmin Luz Morales Moreno was also present today. Observed today were several bottles of hand sanitizer stored in the living room (easily accessible to children). Construction equipments (shovel and wheel barrow) and bar-b-q grill with gas tank were observed accessible to children in the back patio area. Photos were taken today.
Based on LPA's observation, LPA determined that the preponderance of evidence has been met. There is enough supporting information to prove the above allegation is SUBSTANTIATED, see deficiencies cited on the attached LIC 9099D. Exit interview was conducted with Mrs. Rivera. A copy of this report and appeal rights were provided today. The Notice of Site Visit was provided and observed posted for 30 days. This notice shall remain posted for 30 days.
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: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
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 3
Control Number 51-CC-20220228132449
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: RIVERA, KARINA FAMILY CHILD CARE
FACILITY NUMBER: 376626229
VISIT DATE: 03/02/2022
NARRATIVE
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 51-CC-20220228132449
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: RIVERA, KARINA FAMILY CHILD CARE
FACILITY NUMBER: 376626229
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
03/02/2022
Section Cited
CCR
102417(g)
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OPERATION OF A FAMILY CHILD CARE HOME. The home shall be free from defects or conditions which might endanger a child.

This requirement was not met as evidenced by:
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CORRECTED TODAY. Mrs. Rivera removed the bottles of Hand Sanitizer and installed a barricade to make the construction equipment and bar-b-q grill inaccessible to children.
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Based on LPA's observation, children have access to several bottles of Hand Sanitizer (in the living room); construction equipment (shovel and wheel barrow) and bar-b-q grill (with gas tank) in the patio area.
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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: 03/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3