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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376600145
Report Date: 10/03/2022
Date Signed: 10/03/2022 04:18:21 PM

Unsubstantiated


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
08/08/2022 and conducted by Evaluator Keturah Lane
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20220808135504
FACILITY NAME:ALEXA'S PLAYCFACILITY NUMBER:
376600145
ADMINISTRATOR:NORA CAMACHOFACILITY TYPE:
850
ADDRESS:3685 KEARNY VILLA ROADTELEPHONE:
(858) 966-8555
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:92CENSUS: 43DATE:
10/03/2022
UNANNOUNCEDTIME BEGAN:
03:40 AM
MET WITH:Nora CamachoTIME COMPLETED:
04:35 PM
ALLEGATION(S):
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Daycare child sustained injury in bathroom due to lack of supervision by staff
INVESTIGATION FINDINGS:
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On 10/3/22 at 3:40 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced complaint inspection for the complaint received on 8/8/22 for the purpose of delivering findings regarding the above allegation. Upon arrival, LPA Lane met with facility representative Director Nora Camacho and toured the facility. Census was 43 children with 19 staff in 5 classrooms. LPA observed appropriate capacity and ratios. LPA also observed appropriate care and supervision during the inspection. It was alleged that a daycare child sustained an injury in the bathroom due to lack of supervision by staff.
The Department fully investigated the complaint and obtained information from facility file review, facility documents, medical report and interviews with complainant, child in classroom, staff members and parents of enrolled children. Based upon information obtained from these sources, it was determined that a staff member was supervising in the bathroom when the incident occurred. (continued on LIC9099-D...)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
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 2
Control Number 51-CC-20220808135504
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: ALEXA'S PLAYC
FACILITY NUMBER: 376600145
VISIT DATE: 10/03/2022
NARRATIVE
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The child was running and playing with another friend and staff member reminded the children to walk in the bathroom. Although the allegation may have happened or is valid, there was not a preponderance of evidence to prove that the injury occurred due to lack of supervision, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with facility representative Director Nora Camacho. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2