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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600145
Report Date: 12/16/2024
Date Signed: 12/16/2024 05:09:33 PM

Document Has Been Signed on 12/16/2024 05:09 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: 65DATE:
12/16/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Nora CamachoTIME VISIT/
INSPECTION COMPLETED:
05:30 PM
NARRATIVE
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On 12/16/24, LIcensing Program Analysts (LPAs) Keturah Lane and Hanna Lucas conducted a case management inspection to follow up on an incident reported by the facility to Licensing on 10/25/24. Upon arrival, LPAs were greeted by Director Nora Camacho and toured the facility. LPAs observed a total of 65 children (21 were toddlers) in 5 classrooms with 18 staff members. LPAs observed appropriate capacity, ratios and supervision while at the facility.

The facility reported an incident that occurred on Thursday 10/24/24 where C1 was left unattended in the classroom hallway for approximately 1 minute and was found by a supervisor (S6). A teacher (S1) had left one of the classrooms with two children to obtain some materials. There was some confusion as to whether C1 slipped out of the classroom following S1 or if C1 left the classroom without the remaining staff (S2-S5) noticing.

During this visit, LPAs interviewed staff members involved in the incident and obtained LIC9040 facility roster and updated LIC500 personnel roster.

C1's parent was contacted by S1 regarding the incident. Director installed bells on the doors so staff would hear them opening and closing. Also, a new rule was applied to the children in all classrooms that doors are "teacher or parent touch" only. A new number line was also put up in the classroom to help the staff know their ratio numbers at all times. Further individual staff training was done by Director to improve teamwork and communication in the classroom.

See LIC809-D for Type B deficiency cited.

Exit interview conducted and report was reviewed with Director Nora Camacho. Notice of Site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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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Document Has Been Signed on 12/16/2024 05:09 PM - It Cannot Be Edited


Created By: Keturah Lane On 12/16/2024 at 04:36 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ALEXA'S PLAYC
FACILITY NUMBER: 376600145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/30/2024
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation. This requirement was not met as evidenced by...
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Director held a classroom meeting to retrain staff on communication and supervision. Director also installed bells on the doors, started a new "teacher touch" rule for the children regarding doors and a number line to help with watching ratio. DIrector will have staff sign an agenda stating the received the training and send to LPA Lane via e-mail by 12/30/24.
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Based upon staff interviews and unusual incident report received from facility, C1 was left unsupervised for approximately one minute in the hallway and staff were unaware she had left the classroom which is 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.
SUPERVISOR'S NAME:Tashima Daniel
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2024


LIC809 (FAS) - (06/04)
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