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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376100341
Report Date: 12/15/2021
Date Signed: 12/15/2021 11:14:31 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
11/18/2021 and conducted by Evaluator Nancy Diaz
COMPLAINT CONTROL NUMBER: 51-CC-20211118162858
FACILITY NAME:WIMBERLY, AMY FAMILY CHILD CAREFACILITY NUMBER:
376100341
ADMINISTRATOR:AMY WIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 395-5849
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY:14CENSUS: 9DATE:
12/15/2021
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Amy Wimberly TIME COMPLETED:
11:45 AM
ALLEGATION(S):
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9
Licensee is not following COVID protocol.
INVESTIGATION FINDINGS:
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On 12/15/21 @ 10:25AM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced inspection to deliver the findings to the above allegation. Observed present today were 9 children with Mrs. Wimberly and helper Lisa Lancaster. Children were observed engaged in circle time.
During the course of investigation, LPA conducted interviews with the licensee, helper and parents of children in care. Based on LPA interviews with the licensee, helper and parents, the licensee did not follow CDSS/CDPH Covid-19 guidelines/recommendations when Mrs. Wimberly and her husband tested positive for COVID-19. Mrs. Wimberly failed to isolate/quarantine staff/children. Mrs. Wimberly also failed to report this incident to the department. Based on LPAs interviews conducted, the preponderance of evidence standard has been met; therefore the findings is substantiated. California Code of Regulations, Title 22, Division 12 are being cited on the attached lic 9099D. This poses a potential health and safety risk to children in care.
Type B deficiency are cited. Exit interview was conducted with Mrs. Wimberly. Appeal rights were provided. Notice of site visit was observed posted. This shall remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
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-20211118162858
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: WIMBERLY, AMY FAMILY CHILD CARE
FACILITY NUMBER: 376100341
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/15/2021
Section Cited
CCR
1012416.2(c)(3)
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REPORTING REQUIREMENTS. In addition to the events specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C), the licensee shall report the following events to the Department: A communicable disease outbreak when determined by the local health authority.
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Mrs. Wimberly stated that she will report to the department and County Public Health any cases of COVID-19 positive. LPA also provided Mrs. Wimberly a copy of COVID-19 decision trees for Childcare.
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This requirement was not met as evidenced by:
Based on interviews conducted with the licensee, helper and parents of children in care, Mrs. Wimberly failed to report to the department and County Public Health cases of COVID-19 positive.
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Type B
12/15/2021
Section Cited
CCR
102423(a)(2)
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PERSONAL RIGHTS.
To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
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Mrs. Wimberly stated that she will isolate/quarantine staff/children immediately if someone in the daycare test positive for COVID-19.
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This requirement was not met as evidenced by: Based on interviews conducted by the LPA, Mrs. Wimberly failed to isolate/quarantine staff/children when she developed symptoms for COVID-19 virus. Mrs. Wimberly and her husband were both tested positive for COVID-19.
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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: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
11/18/2021 and conducted by Evaluator Nancy Diaz
COMPLAINT CONTROL NUMBER: 51-CC-20211118162858

FACILITY NAME:WIMBERLY, AMY FAMILY CHILD CAREFACILITY NUMBER:
376100341
ADMINISTRATOR:AMY WIMBERLYFACILITY TYPE:
810
ADDRESS:9424 SAGEBRUSH COURTTELEPHONE:
(619) 395-5849
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY:14CENSUS: 9DATE:
12/15/2021
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Amy Wimberly TIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Licensee is exposing daycare children to COVID.
INVESTIGATION FINDINGS:
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On 12/15/2021 @ 10:25AM, LPA Nancy Diaz conducted an unannounced inspection to deliver the findings to the above allegation.
During the investigation LPA conducted interviews with the licensee, staff and parents of children in care. The information obtained is not sufficient to prove or disprove the allegation. Therefore, this allegation is determined to be Unsubstantiated. A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No deficiences are cited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3