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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191224046
Report Date: 11/18/2019
Date Signed: 11/18/2019 04:48:45 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/15/2019 and conducted by Evaluator Isabel Ortega
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20191115112308
FACILITY NAME:VERDUGO HILLS FAMILY YMCAFACILITY NUMBER:
191224046
ADMINISTRATOR:SUZANNE MCMILLENFACILITY TYPE:
850
ADDRESS:6840 FOOTHILL BOULEVARDTELEPHONE:
(818) 352-3255
CITY:TUJUNGASTATE: CAZIP CODE:
91042
CAPACITY:68CENSUS: 45DATE:
11/18/2019
UNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Suzanne McMillenTIME COMPLETED:
04:49 PM
ALLEGATION(S):
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Allegation #1 Qualifications: Unqualified staff providing care and supervision to day-care children
Allegation #2 License: Facility is operating out of ratio
Allegation#3 Lack of Supervision: Facility staff left day care child unattended
INVESTIGATION FINDINGS:
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LPA Isabel Ortega conducted an unannounced 10 day complaint inspection for the purpose of investigating the above allegations. LPA met with Suzanne McMillen, Site Director. Upon arrival LPA observed 45 children and nine staff. LPA toured the facility program classrooms (Blue, Red, Green, and Yellow Birds). LPA received a copy of the roster, reviewed sign in sheets, conducted staff interviews, conducted child interviews, reviewed staff and child files.
The purpose of the inspection is to investigate the above allegations. Basedon parent, staff and child interviews it was disclosed children at times are left unattended due to lack of teacher child ratio. On occasion children were left with unqualified personnel(no ECE units), facility was found to be out of ratio. Based on LPA's observations, interviews which were conducted, documents gathered and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 or Health and Safety Code, are being cited on the attached LIC 9099D.
An exit interview was conducted and a copy of this report, appeal rights and notice of site visit was provided to the Site Director, Suzanne McMillen on this date.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
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 3
Control Number 12-CC-20191115112308
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2019
Section Cited
CCR
101216.3(a)
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101216.3 Teacher-Child Ratio
There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance.

Based on LPA observation, interviews conducted, and record review, facility failed to ensure that teacher child ratios are meet
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Site Director with hire new staff and hold a training on teacher- child ratios and send a copy of the sign in sheet and associate new staff to facility by 12/6/19
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per Title 22, which poses potential health and safety risk to children in care.


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Type B
11/27/2019
Section Cited
CCR
101216.2(e)
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101216.2 Teacher Aide Qualifications and Duties
An aide shall work only under the direct supervision of a teacher

Based on LPA observation, interviews conducted, and record review, facility failed to ensure qualified teachers in the classroom are meet
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Site Director will meet with staff and set a plan in place and email the sign in sheet to the Palmdale Regional Office by 11/27/19
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per Title 22, which poses potential health and safety 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: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20191115112308
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2019
Section Cited
CCR
101229(a)(1)
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Lack of supervision: 101229(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.


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Facility agreed to have a training regaring supervision with all staff during December monthly staff meeting. Facility agreed to submit copy of materials and sign in sheet to the Palmdale Regional Office by 12/6/19.
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Based on LPA's observationn, interviews conducted, and record reviews, children were unsupervised and visual observation was not met at all times, facility did not comply with Title 22 regulations. This poses a potential health and safety 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: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3