376701275-7-26-2019-20-CC-JGAY-BEVTJG-20190809144617

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376701275
Report Date: 07/26/2019
Date Signed: 07/26/2019 02:28:00 PM

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
05/02/2019 and conducted by Evaluator Michelle Hood

PUBLIC

COMPLAINT CONTROL NUMBER: 20-CC-20190502085808

FACILITY NAME:	KIDS DEPOT OF OTAY RANCH		FACILITY NUMBER:	376701275
ADMINISTRATOR:	AIMEE BOIRI		FACILITY TYPE:	830
ADDRESS:	1394 EAST PALOMAR ST. STE. 210		TELEPHONE:	(858) 699-1710
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91913
CAPACITY:	44	CENSUS: 12	DATE:	07/26/2019
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Aimee Boiri, Director		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Child sustained unexplained injury while in care.
Facility is operating out of ratio.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michelle Hood arrived to conduct an unannounced inspection to deliver complaint findings for the above listed allegations. LPA met with Director. It was alleged child sustained unexplained injury while in care and facility is operating out of ratio. Based on interviews conducted with assistant Director and staff members, it was determined that on 04/25/2019, Child #1 (C1) was assessed after parent observed C1 to have an eye injury and bump on head. According to facility staff, C1 did not show signs of injury, nor exhibit any other signs of distress. Staff were unaware of how or when the injuries occurred but suspected the injuries may be self-inflicted. On 04/26/2019, C1’s parent informed facility staff that a subsequent medical assessment was performed by a hospital doctor. Based on evidence obtained, LPA is unable to determine where the injuries occurred or whether a lack of supervision contributed to the injuries.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 20-CC-20190502085808

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: KIDS DEPOT OF OTAY RANCH	FACILITY NUMBER: 376701275
	VISIT DATE: 07/26/2019

NARRATIVE

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A facility tour, review of records and staff and parent interviews, revealed there is an area of the infant classroom not visible to the public from the main sign in area which could give the perception the classroom is operating out of ratio. Parents stated no concerns regarding ratio/capacity.

Due to conflicting statements obtained during the course of the investigation, the above allegations are found to be UNSUBSTANTIATED meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Licensee was provided appeal rights (LIC9058 01/16) and their signature on this form acknowledges receipt of these rights. Provided Notice of Site Visit. LPA observed that LIC 9213 was posted. No deficiencies cited. An exit interview was conducted.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019

LIC9099 (FAS) - (06/04)

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