191501150-8-3-2022-33-CC-BVON-CJUKZS-20221003082110

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191501150
Report Date: 08/03/2022
Date Signed: 08/03/2022 05:33:50 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/25/2022 and conducted by Evaluator Lilli Babcock

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20220725161621

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: 15	DATE:	08/03/2022
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Director, Nicole Rodriguez		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility is operating out of ratio
Children left under the care and supervision of unqualified staff

INVESTIGATION FINDINGS:

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On 8/3/22 Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced Initial Complaint inspection visit to the above facility. A COVID risk assessment was conducted, and appropriate PPE was used by LPA.

At 7:37 am LPA arrived at facility and attempted to locate the Director. LPA noticed an open classroom door at the end of the hall. LPA observed Staff #1 alone with 15 school-age children in the School-age One Classroom. LPA then walked by another classroom (infant room) and observed Staff #2 alone with 5 infants. LPA located Director, Nicole Rodriguez, in the Preschool Two Classroom with 5 preschool children. LPA explained to director the reason for the visit.

Regarding the allegation that the facility is operating out of ratio, based on LPA observation, this allegation is substantiated.
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Substantiated

Estimated Days of Completion: 8

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Lilli Babcock	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

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

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20220725161621

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 08/03/2022

NARRATIVE

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During the visit, LPA interviewed 6 staff and obtained Child Supervision Records (CSRs) for the preschool and school-age classrooms, Personnel Record (LIC 500), and Children's Roster (LIC 555).

At 12:33 pm, LPA observed Staff #4 supervising 14 children in the School-Age 1 classroom. The file review for Staff #4 did not have any transcripts showing teacher unit qualifications.

Regarding the allegation that children left under the care and supervision of unqualified staff, based on LPA observation and staff file reviews of staff supervising children during this inspection, this allegation is substantiated.

Based on LPA observations, interviews, and records review, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations, is being cited on the attached LIC 9099-D.

LPA Lilli Babcock informed facility representative, Nicole Rodriguez that this report dated 8/3/2022 document(s) (number of Type A citation) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Lilli Babcock informed the facility representative to provide a copy of this licensing report dated 8/3/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview conducted and report was reviewed with Director, Nicole Rodriguez.

Page 2 of 2 .....End of Report

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Lilli Babcock	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 33-CC-20220725161621

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/03/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/04/2022 Section Cited CCR 101516.5(b)(1)	1 2 3 4 5 6 7	101516.5(b)(1) A teacher shall supervise no more than 14 children... This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director will ensure that classrooms maintain proper teacher-child ratio.
	8 9 10 11 12 13 14	Based on LPA observation of 1 teacher supervising 15 children, director did not ensure ratio was being met in 1 out of 1 school-age classrooms which poses an immediate health and safety risk to persons in care.	8 9 10 11 12 13 14
Type A 08/04/2022 Section Cited CCR 101216.1(b)(1)	1 2 3 4 5 6 7	101216.1(b)(1) A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units... This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Director will ensure that teachers have required courses and units.
	8 9 10 11 12 13 14	Based on interview, staff #4 (S4) stated he did not know if he was qualified to be a teacher; and record review, file for S4 did not have any transcripts, director did not ensure teacher qualifications for 3 of 5 staff, which poses an immediate health and safety risk to persons in care.	8 9 10 11 12 13 14

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: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Lilli Babcock	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022

LIC9099 (FAS) - (06/04)

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