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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600145
Report Date: 07/25/2025
Date Signed: 07/25/2025 03:35:22 PM

Document Has Been Signed on 07/25/2025 03:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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:ALEXA'S PLAYCFACILITY NUMBER:
376600145
ADMINISTRATOR/
DIRECTOR:		GABRIELA PADILLAFACILITY TYPE:
850
ADDRESS:3685 KEARNY VILLA ROADTELEPHONE:
(858) 966-8555
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 52DATE:
07/25/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Nora CamachoTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 7/25/24 at 1:10PM, Licensing Program Analyst (LPA) Mahjoba Mohsini conducted an unannounced case management visit to to follow up on an unusual incident reported by the facility on 7/17/25.

Upon arrival, LPA met with facility director, Nora Camacho, toured the facility, interviewed staff and reviewed facility records. LPA observed a total of 52 children, 5 staff with the following ratios during naptime:

  • Octopus classroom had 12 children with staff member Ms. Doan
  • Dolphins classroom had 18 children with staff member Ms. Slaughter
  • Whales classroom (Toddlers) had 6 toddlers with staff member Ms. Symington
  • Walrus classroom (Toddlers) had 8 toddlers with staff member Ms. Clark
  • Shark classroom had 8 children with staff member Ms. Quejada

The report involved a child in care who ingested a small portion of a food item containing a suspected allergen while at the playground. According to facility representative and Staff (S1), food is not usually served outside, but due to implementation of new communication resource, Staff (S2), had permitted Child (C2) have snack by the playground where C1 accessed the potential allergen. The item was not served by staff.

According to staff, the children were under visual supervision when the C1 approached and took a bite of C2's food item. S2 intervened, followed the child’s medical plan, and took C1 to S1's classroom who is trained on emergency response and also contacted the child’s parent. The child was monitored and no adverse outcome was reported.

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Mahjoba Mohsini
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: ALEXA'S PLAYC
FACILITY NUMBER: 376600145
VISIT DATE: 07/25/2025
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During the visit, LPA interviewed involved staff, reviewed facility files, including medical and emergency plans and observed the classroom environment. LPA confirmed that allergy precautions were posted, and staff had completed the required training. Visual supervision and emergency response appeared consistent with regulatory expectations.

Based on the information gathered, including interviews, file review, and observations, staff responded appropriately, and the incident appears to have been accidental.

No deficiencies were cited during today’s visit.

Exit interview was conducted and report was reviewed with facility representative Nora Camacho. Notice of Site visit was provided to facility representative and is to remain posted at the facility for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Mahjoba Mohsini
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2025
LIC809 (FAS) - (06/04)
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