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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191224046
Report Date: 07/16/2021
Date Signed: 07/16/2021 03:30:38 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
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: 39DATE:
07/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:11 PM
MET WITH:Chelsea LawrenceTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Ortega met with the facility Director Chelsea Lawrence, 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(Red, Green, Yellow and Blue) with a total of 39 preschool children and 7 staff. The center operates Monday through Friday 7:00AM - 6:00PM.
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 personal individual bottles and cups. Appropriate napping equipment is available and stored properly(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 hand air drying blower readily available. Additional sinks are located in each of the class rooms.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VERDUGO HILLS FAMILY YMCA
FACILITY NUMBER: 191224046
VISIT DATE: 07/16/2021
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Wellness Policy: Children are inspected for illnesses as they arrive (temperature checks are conducted). 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 is available in personal bottles and cups(labeled) refilled as needed. 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, and tricycles. Large jungle gym is anchored.
There is a kitchen (off limits) with refrigerator/freezer (2) one for staff and one for children 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 on the kitchen wall. LPA observed an appropriate amount of snacks. The chemicals are kept separate from the food.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VERDUGO HILLS FAMILY YMCA
FACILITY NUMBER: 191224046
VISIT DATE: 07/16/2021
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Sign in and out sheets were reviewed, Facility utilizes an app BrightWheel for check in and outs and other features. The parent board was reviewed and has all of the required forms posted. Snack Menu is posted. Fire/earthquake drills are current last recorded date conducted was on February 5, 2021. Roster being updated as child enroll and 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 expires 07/2023.
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 Lawrence on this date.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
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