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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600145
Report Date: 10/03/2022
Date Signed: 10/03/2022 04:15:01 PM

Document Has Been Signed on 10/03/2022 04:15 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
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: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 43DATE:
10/03/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Nora CamachoTIME COMPLETED:
03:35 PM
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On 10/3/22 at 3:05 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced case management inspection. The reason for the visit is to follow up on an unusual incident reported by the facility on 9/14/22. The Director reported the oven started producing smoke and flames inside the oven. Staff pulled the fire alarm, alerted security and called 911. The fire department arrived and cleared the area after investigating. It was found that buildup inside the oven created the smoke and flames.

Upon arrival, LPA met with Director Nora Camacho and toured the facility. Census at the facility was 43 children with 19 staff members in 5 classrooms. LPA Lane observed appropriate capacity and ratios. LPA Lane observed appropriate care and supervision during inspection.

LPA advised Director to implement a regular cleaning schedule for all appliances and post it in an area that all staff are aware of the schedule. Director stated that the oven is not currently in use and a sign is posted to not use it. Director stated they are replacing the oven soon.

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
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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