<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191501150
Report Date: 08/11/2022
Date Signed: 08/11/2022 06:32:51 PM


Document Has Been Signed on 08/11/2022 06:32 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 SITEFACILITY NUMBER:
191501150
ADMINISTRATOR:SUSETTE SEPULVEDAFACILITY TYPE:
840
ADDRESS:12510 E. HADLEY ST.TELEPHONE:
(562) 306-5989
CITY:WHITTIERSTATE: CAZIP CODE:
90601
CAPACITY:105CENSUS: 21DATE:
08/11/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Nicole RodriguezTIME COMPLETED:
09:30 AM
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 (LPAs) Lilli Babcock and Roxana Lopez conducted an unannounced POC (plan of correction) inspection to ensure that the two Type A deficiencies cited on 8/3/22 have been cleared. LPAs met with Nicole Rodriguez, Director, who guided analysts on a tour of the facility. There were 21 children present during this inspection. The following was observed:

School-age Classroom 1 contained 1 teacher and 14 children. School-age Classroom 2 contained 1 teacher and 7 children. Teacher-Child Ratio was met with qualified staff.

LPAs also observed LIC 9224s signed and in children’s files

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

LPA’s cleared deficiency on this date and provided a copy of the Licensing Report to Nicole Rodriguez, Director. LPA’s issued POC clearance letter during the visit.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

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.

Page 1 of 1

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Lilli BabcockTELEPHONE: (323) 981-3350
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)
Page: 1 of 1