191224046-6-3-2019-12-CC-TLAN-BCSSHB-20190603135317

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191224046
Report Date: 06/03/2019
Date Signed: 06/03/2019 01:53:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	VERDUGO HILLS FAMILY YMCA		FACILITY NUMBER:	191224046
ADMINISTRATOR:	LINDSEY WHITESIDE CORTES		FACILITY TYPE:	850
ADDRESS:	6840 FOOTHILL BOULEVARD		TELEPHONE:	(818) 352-3255
CITY:	TUJUNGA	STATE: CA	ZIP CODE:	91042
CAPACITY:	68	CENSUS: 59	DATE:	06/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:26 AM
MET WITH:	Nicole Ambriz		TIME COMPLETED:	02:00 PM

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	Licensing Program Analyst (LPA) Lawson met with the facility Lead Teacher Ambriz and Director Suzanne McMillen, for the purpose of conducting a Random Annual Inspection for the preschool. A tour of the facility was conducted. Upon arrival LPA observed four classrooms with a total of 59 preschool children and 10 staff. The center operates Monday through Friday 7:00AM - 6:30PM. Furniture and equipment were inspected for age appropriateness and good repair. All rooms are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are labeled cubbies for children's belongings. LPA observed age appropriate toys and materials. Drinking water is available inside the classrooms in the form of water fountains. Appropriate napping equipment is available (cots). There is a fire extinguisher, smoke detector and a carbon monoxide detector on the premises. There are First Aid Kits available throughout the facility. LPA inspected and observed two clean bathrooms one for girls (2 toilets and 3 sinks) and boys (1 toilet, 1 urinal and 2 sink). Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available. Additional sinks are located in each of the classrooms.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: VERDUGO HILLS FAMILY YMCA	FACILITY NUMBER: 191224046
	VISIT DATE: 06/03/2019

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

Wellness Policy: Children are inspected for illnesses as they arrive. There is a separate area for isolation for ill children in the office area (cot available).

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. The play area has concrete and rubber padding. The area was observed to be free of debris. There is an area for shade and rest. Water fountain are available. Play area was inspected and found to be free of hazards and inaccessibility to bodies of water. There is a large jungle gym, a climbing apparatus, Little Tykes climbables and bikes. Large jungle gym is anchored.

There is a clean kitchen (off limits) with refrigerator/freezer (2) and microwave oven. The facility provides am/pm snack. Children bring their lunches, which are labeled and stored in the refrigerator (if needed) and heated (if needed) during lunch. Allergy lists are posted in the kitchen. LPA observed an appropriate amount of snacks. The chemicals are kept separate from the food.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: VERDUGO HILLS FAMILY YMCA	FACILITY NUMBER: 191224046
	VISIT DATE: 06/03/2019

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

Sign in and out sheets were reviewed. The parent board was reviewed and has all of the required forms posted. Snack Menu is posted. Fire/earthquake drills current. Roster current.

Teacher child ratios were observed and staff name recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.
Children's records and staff records were reviewed. Staff are certified in Pediatric CPR and First Aid expire 06/05/2020.

Additional forms and a copy of Title 22 Regulations may be obtained at the department's website www.ccld.ca.gov.

--Director was informed of responsibility to report suspected Child Abuse, 1-800-827-8724
--Child Care Centers (Disaster Planning information):https://cccld.childcarevideos.org/child-care-center-operators/disaster-planning-and-fire-safety/
--Child Care Videos: https://ccld.childcarevideos.org
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

No deficiencies. A copy of this report was read and provided to Director McMillen on this date.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3