191501150-8-11-2022-33-CC-RLOZ-CH83NG-20220811182356

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191501150
Report Date: 08/11/2022
Date Signed: 08/11/2022 06:24:05 PM

Document Has Been Signed on 08/11/2022 06:24 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	WHITTIER YMCA SCHOOL AGE SITE		FACILITY NUMBER:	191501150
ADMINISTRATOR:	SUSETTE SEPULVEDA		FACILITY TYPE:	840
ADDRESS:	12510 E. HADLEY ST.		TELEPHONE:	(562) 306-5989
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90601
CAPACITY:	105	CENSUS: 21	DATE:	08/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Director Nicole Rodriguez		TIME COMPLETED:	06:40 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 Analysts (LPA) Roxana Lopez and Lilli Babcock conducted an unannounced annual/random inspection on this date. A risk assessment was conducted upon entry and appropriate PPE was used. LPAs met with Director, Nicole Rodriguez who guided LPAs on a tour of the facility. This facility operates Monday-Friday from 6:30am-6:30pm during the summer. This is a School Age Program that is licensed for 105 children. Per Director, there’s 50 children currently enrolled. There is also a preschool on site license # 198019117 and an infant license # 19802067. LPAs toured the areas according to the facility sketch on file. Per Directors, no alterations have been made and LPAs observed none. The facility consists of 1 large classroom with a retractable partition wall. Each area was inspected. There were 2 staff with 21 children in this room. Teacher-child ratio is met. All adults present have obtained a criminal record clearance or exemption on file. The following was observed during the tour of facility: Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. There is available drinking water in form of water bottles and water dispensers. The first aid kit is kept in the large room. LPAs observed the carbon monoxide detector located in the large classroom and found it to be operational. There are restrooms located across the office available for the children to use. The restrooms were observed to be clean, with sufficient supplies for children to use. LPA’s did observed a leak coming ------------------------------------------------ pg 1 of 3 ---------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WHITTIER YMCA SCHOOL AGE SITE	FACILITY NUMBER: 191501150
	VISIT DATE: 08/11/2022

NARRATIVE

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from a sink in the girls restroom- the problem was fixed during inspection. Per director, the isolation area is located in the director's office and the staff restroom will be used.

The facility has a kitchen where meals and snacks are prepared and cooked for the children. The kitchen was inspected and observed to be clean, orderly, and sufficient storage for supplies. The facility provides breakfast, lunch and pm snack. The menus are posted on parent boards a month in advanced.

The gym is used as an outside playground space. Director Nicole Rodriguez stated that the program was licensed for the gym. Gym equipment was inspected for safety, cushioning material, good repair and appropriateness. LPA’s advised Director that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. The children have access to water bottles and water dispensers during play. The gym is located next to three pools are located on the east side of the building. The entrance to the large pool room is a double glass door with a glass wall where people can look into the pool room. The double doors are locked to prevent children from gaining access to the pools and have an alarm that sound when doors are opened. Per Director, during summer the children use the swimming pool once a week, teachers are in the swimming pool with the children and life guards are present. The pool is closed for the community when children are using it.

Per director there's no fire arms or weapons on the property. The fire/earthquake drill log was available- last one was conducted on 8/11/2022. Sign in and out sheets were reviewed and found to be accurate.

LPAs also reviewed criminal record clearances, children and staff records. LPA’s observed that staff 1 & 2 are missing a health screening report and Staff # 1 is missing immunization.

LPA issued a copy of the LIC 857 Children’s Records Review and the LIC859 Staff Records Review to the licensee during this inspection.------------ pg 2 of 3 --------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WHITTIER YMCA SCHOOL AGE SITE	FACILITY NUMBER: 191501150
	VISIT DATE: 08/11/2022

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

Director, Nicole Rodriguez that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with Director, Nicole Rodriguez----------------------- pg 3.of 3 -------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

LIC809 (FAS) - (06/04)

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