Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376600318
Report Date: 05/18/2018
Date Signed 05/18/2018 03:41:34 PM


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
05/03/2018 and conducted by Evaluator Vicky Williamson
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20180503081737
FACILITY NAME:KINDERCARE CUYAMACA CENTERFACILITY NUMBER:
376600318
ADMINISTRATOR:MARITZA RENTERIAFACILITY TYPE:
850
ADDRESS:9735 CUYAMACA STREETTELEPHONE:
(619) 562-3423
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:72CENSUS: 51DATE:
05/18/2018
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Jennifer PhillipsTIME COMPLETED:
03:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is in disrepair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Onsite inspection made by Licensing Program Analyst (LPA) Vicky Williamson to complete complaint investigation initially conducted on 5/10/18. Met with Assistant Director Jennifer Phillips. The following ratios were observed during inspection:

Room #4 (2 - 3 years) 17 napping children present with 2 qualified teachers.
Room #5 (4 - 5 years) 22 napping children present with 2 qualified teachers.
Room #7 (3 - 4 years) 12 napping children present with 1 qualified teacher.

It was alleged that facility is in disrepair. Interviews were conducted with the director, several staff members, a witness, day care children, and a day care parent. Staff members stated on 5/3/18, they were informed by a day care parent that there was water on the floor in the bathroom inside of preschool classroom #7. Staff members observed 2 puddles of water on the bathroom floor, and that the toilet appeared to be leaking water onto the floor. Staff stated that the water was immediately removed from the floor, and the Director was notified.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2018
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 5
Control Number 20-CC-20180503081737
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: KINDERCARE CUYAMACA CENTER
FACILITY NUMBER: 376600318
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/18/2018
Section Cited
CCR
101239(e)(4)
1
2
3
4
5
6
7
Fixtures, Furniture, Equipment and Supplies. All toilets, hand-washing and bathing facilities shall be kept in safe and sanitary operation and shall be ADA compliant. The requirement is not met as evidence by: Based on staff interviews and a day care parent, it was determined on 5/3/18, that there was water on the floor in the bathroom inside of preschool classroom #7.
1
2
3
4
5
6
7
Per Director and documentation obtained by LPA, toilet was repaired on 5/7/18. POC cleared during inspection.
8
9
10
11
12
13
14
This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2018
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 20-CC-20180503081737
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: KINDERCARE CUYAMACA CENTER
FACILITY NUMBER: 376600318
VISIT DATE: 05/18/2018
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Per Director and documentation obtained by LPA, a work order was submitted to facility maintenance reporting a leaking toilet on 5/3/18, and repaired on 5/7/18.

Based on the information obtained during the course of the investigation, the preponderance of evidence standard has been met that the facility’s toilet was in disrepair, resulting in water on the bathroom floor, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations per Title 22, Division 12, Chapter 1. Please refer to LIC 9099D for deficiency cited. Facility was provided a copy of the appeal rights form LIC 9058 and the signature on this form acknowledges receipt of these rights.

Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted.

An exit interview was conducted.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2018
LIC9099 (FAS) - (06/04)
Page: 3 of 5