197403360-5-14-2024-12-CC-CHEH-D59L7H-20240514083019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197403360
Report Date: 05/13/2024
Date Signed: 05/14/2024 08:30:32 AM

Document Has Been Signed on 05/14/2024 08:30 AM - 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	YMCA METRO LA/ANTELOPE VALLEY QUARTZ HILL		FACILITY NUMBER:	197403360
ADMINISTRATOR:	CANDACE BEDNAR		FACILITY TYPE:	840
ADDRESS:	41820 50TH STREET WEST		TELEPHONE:	(661) 943-3303
CITY:	QUARTZ HILL	STATE: CA	ZIP CODE:	93536
CAPACITY:	105	CENSUS: 21	DATE:	05/13/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:48 PM
MET WITH:	Valerie Montez		TIME COMPLETED:	04:30 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	On 5/13/2023, Licensing Program Analyst (LPA) Carol Heath met with the teacher, Valerie Montez to conduct a Random/Annual inspection for the school-age program. The director, Jessica Hernandez, is out the town. LPA toured and inspected the facility in accordance with the facility sketch. During today’s inspection, there are 21 school-age children present, with 3 teachers and the director. There is one school-age classroom. The facility operates from Mon. - Fri., 6:00 am to 8:00 am and 1:45 pm to 6:00 pm. Incidental Medical Services (IMS) were discussed. Physical Plant: LPA toured and inspected the preschool classrooms. Furniture and equipment were inspected for age appropriateness and good repair. The room was observed to be clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies with the children's photos and names for personal belongings. LPA observed age-appropriate toys, equipment, and materials. Drinking water is available inside the classroom through a dispenser and disposable cups. The trash can have a lid. Restrooms: LPA inspected and observed a boy's bathroom (2 toilets and 2 sinks) and a girls' bathroom (4 toilets and 2 sinks) located in the front of the facility. LPA observed that soap, toilet paper, and paper towels were readily available. Water temperature is appropriate. The facility has a surveillance system on the premises that covers each classroom and outside play area. The fire extinguisher, smoke detector, and carbon monoxide detector were observed to be operable. A large emergency bin was observed inside the classroom. An emergency backpack is located beside the door.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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: YMCA METRO LA/ANTELOPE VALLEY QUARTZ HILL	FACILITY NUMBER: 197403360
	VISIT DATE: 05/13/2024

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The outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The facility has one playground area for school-age children. Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. There are concrete areas for active play. The area was observed to be free of debris from hazards, holes, broken items, debris, and cushioning material underneath. No bodies of water were observed. There are areas for shade and rest. School-age children have disposable cups for water. The facility teachers will bring the children to school playground to play.
LPA observed a first aid kit with the full required materials and supplies, a First Aid Kit menu in the office, fire extinguishers, and carbon monoxide detectors throughout the center. There is a Fire Drill/Earthquake log (12/2023) posted in the office and a current Roster available.
The parent board was reviewed and has posted all the required forms. Fire/earthquake drills current. Children are inspected for illnesses as they arrive. A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Director administers medication and documents the dosage, date, and time on a log. Medication is brought and taken home by the parent daily. Medication is labeled correctly and stored in its original container. There are currently one children in care will need IMS. However, the facility does not have IMS plan for the child. There is a mat available for ill children. An isolation is next to director’s desk for ill children to wait for the parents.
Sign-in and out sheets were observed. The Teacher-to-child ratio was observed, and staff names were recorded. Care and supervision were evaluated to determine if children's basic needs were met and appropriate. LPA observed a parent board consisting of licensing required postings. Fire/earthquake drills current.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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: YMCA METRO LA/ANTELOPE VALLEY QUARTZ HILL	FACILITY NUMBER: 197403360
	VISIT DATE: 05/13/2024

NARRATIVE

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Staff Records/ Children Records Children's records and staff records were reviewed. LPA verified at least 1 staff person present with current CPR and First Aid Training. All staff complete the Mandated Reporter training every 2 years. All staff receive Measles, Pertussis, and Influenza vaccinations. All staff have required fingerprinting associated with the facility.
LPA observed that 5 children's files. There are only 1 child contained all required licensing documents.
Food Service: There is a clean, fully equipped refrigerator and cabinet for snacks that are provided to school age children.
Cleaning solutions and other chemicals are kept in a cabinet above the sink with the lock-in classroom and the main building's maintenance room. Soaps, detergents, cleaning compounds, or similar substances are stored separately from food supplies. Drinking water is available inside the classrooms through water pitchers and disposable cups.
The following general information was discussed during this inspection:

Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

*All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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: YMCA METRO LA/ANTELOPE VALLEY QUARTZ HILL	FACILITY NUMBER: 197403360
	VISIT DATE: 05/13/2024

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Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state-licensed facility to another using form LIC 9184

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children

**Center Director advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation (call within 24 hours and submit a written report within 7 days) and on the form LIC624. The Center reminded to review updates/regulations as well as quarterly updates on the Department website. The "Notification of Parent's Rights" poster must be posted in an area of the center accessible to parents. The information regarding new legislation with regard to exemptions and parents' rights was also discussed.

Criminal Record Clearance - Child Care Centers Licensee [or facility representative] was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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: YMCA METRO LA/ANTELOPE VALLEY QUARTZ HILL	FACILITY NUMBER: 197403360
	VISIT DATE: 05/13/2024

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Lead Testing – Child Care Centers (CCC) CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
For the following scenarios use the below un-bolded language: • CCC COMPLETED TESTING AND IS IN THE PROCESS OF REMEDIATING LEAD EXCEEDANCES, or • CCC COMPLETED SAMPLING BUT THE TEST RESULTS ARE NOT YET AVAILABLE, or • CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE, or • CCC TESTING DEADLINE HAS NOT PAST LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Safe Sleep - Child Care Centers and Family Child Care Homes LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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: YMCA METRO LA/ANTELOPE VALLEY QUARTZ HILL	FACILITY NUMBER: 197403360
	VISIT DATE: 05/13/2024

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Incidental Medical Services (IMS) - IF THERE IS NO CHILD AT THE FACILITY THAT CURRENTLY NEEDS IMS, USE AS FOLLOWS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Notice of Site Visit - Centers and Family Child Care Homes A notice of site visit was given and must remain posted for 30 days.

Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

An exit interview was conducted, and the report was reviewed with the teacher, Valerie Montez.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

LIC809 (FAS) - (06/04)

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