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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370806490
Report Date: 06/21/2022
Date Signed: 06/21/2022 10:09:05 AM

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
05/27/2022 and conducted by Evaluator Michelle Hood
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20220527122147
FACILITY NAME:NHA - EUCLID AVENUE HEAD STARTFACILITY NUMBER:
370806490
ADMINISTRATOR:DEBORAH FAVILAFACILITY TYPE:
850
ADDRESS:210 SOUTH EUCLID AVENUETELEPHONE:
(619) 264-3577
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:44CENSUS: 4DATE:
06/21/2022
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Deborah Favila, DirectorTIME COMPLETED:
10:25 AM
ALLEGATION(S):
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Staff did not safeguard daycare child's personal belongings.
INVESTIGATION FINDINGS:
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On 06/21/2022 at 9:10 AM, Licensing Program Analyst (LPA) Michelle Hood conducted an unannounced complaint inspection and met with the Director, Deborah Favila. LPA disclosed the purpose of the inspection and was granted entry into the facility by the director. The director led LPA on a tour of the facility. LPA inspected the following areas: Classroom #1 there was four children with two staff playing outside. Classroom #2 is under quarantine.

LPA interviewed the reporting party, director, staff, and parents. Based on interviews it was disclosed two children were taken to the facility restroom to have their soiled clothing changed. The staff did not check each child’s labeled clothing bag to ensure the correct clothes were being placed on the right child. Since the incident, the facility assigns one staff daily to ensure this does not occur in the future.

The preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC 9099D.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
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 5
Control Number 20-CC-20220527122147
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: NHA - EUCLID AVENUE HEAD START
FACILITY NUMBER: 370806490
VISIT DATE: 06/21/2022
NARRATIVE
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An exit interview was conducted and the report was reviewed with the director. The director was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 20-CC-20220527122147
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: NHA - EUCLID AVENUE HEAD START
FACILITY NUMBER: 370806490
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2022
Section Cited
CCR
101216(a)
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101216(a) Personnel Requirements. Child care center personnel shall be competent to provide the services necessary to meet the individual needs of children in care and shall at all times be employed in numbers sufficient to meet those needs. This requirement is not met as evidenced by:
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On 06/06/2022, the director stated the facility started assigning one staff daily to take one child at a time to the restroom when soiled clothing needs to be changed. The staff checks the label on the bag then again before placing the clothing on the child.
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Based on interviews conducted, the staff failed to ensure two children were changed in their clothing from the separate labeled emergency clothing bags. Interviews conducted with staff and daycare parents stated the staff did not check
the two separate bags before placing the clothing on the children. This poses a potential health and safety risk to children 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.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5