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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 372001020
Report Date: 10/26/2023
Date Signed: 01/16/2024 12:39:42 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 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
10/19/2023 and conducted by Evaluator Annette Sutherland
COMPLAINT CONTROL NUMBER: 51-CC-20231019083454
FACILITY NAME:COLLEGE AVENUE PRE-SCHOOLFACILITY NUMBER:
372001020
ADMINISTRATOR:LARA BLOUINFACILITY TYPE:
850
ADDRESS:4747 COLLEGE AVENUETELEPHONE:
(619) 583-7111
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:180CENSUS: 146DATE:
10/26/2023
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Lara BlouinTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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THIS IS AN AMENDED VERSION OF THE ORIGINAL REPORT

Staff does not keep day-care children's personal information confidential.
INVESTIGATION FINDINGS:
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On 10/26/23 at 8:15 am Licensing Program Analyst (LPA) Annette Sutherland conducted an unannounced complaint inspection regarding the above allegation. Upon arrival, LPA Sutherland met with Director Laura Blouin and toured the facility. Census was 146 children and also present were 29 staff members. LPA reviewed relevant documentation and conducted interviews with staff, parents and potential witnesses. Information obtained during the investigation confirmed that a staff member shared confidential information about a child with an unauthorized party on one verified occasion. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 or Health and Safety Code, are being cited on the attached LIC 9099D. Exit interview was conducted with Director Lara Blouin and a Notice of Site Visit was provided. Notice of Site visit was given, posted and will remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
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 51-CC-20231019083454
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: COLLEGE AVENUE PRE-SCHOOL
FACILITY NUMBER: 372001020
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/26/2023
Section Cited
CCR
101221(c)
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101221 Child's Records (c) All information and records obtained from or regarding children shall be confidential. This requirement is not met as evidenced by:
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Correction has been made Director has provided training regarding Hipa laws and parent child confidentiality on 10/17/23. Director will send provide written documentation to LPA Annette.Sutherland@dss.ca.gov by 10/27/23.
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Facility disclosed confidential information of children in care which poses a potential health, safety and personal rights 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: Renesha Askew
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
LIC9099 (FAS) - (06/04)
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