197419963-6-6-2019-30-CC-MJVZ-BCVRT4-20190606131744

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419963
Report Date: 06/06/2019
Date Signed: 06/06/2019 01:17:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	YMCA OF METRO LA CALABASH CHARTER ACADEMY		FACILITY NUMBER:	197419963
ADMINISTRATOR:	RACHEL HERNANDEZ		FACILITY TYPE:	840
ADDRESS:	23055 EUGENE STREET		TELEPHONE:	(818) 668-2611
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	60	CENSUS: 48	DATE:	06/06/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Rachel Hernandez, Center Director and Ashley Russell, Senior Program Director		TIME COMPLETED:	01:32 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 Analyst (LPA) Martha Vasquez met with Rachel Hernandez, Center Director and Ashley Russell, Senior Program Director to conduct an unannounced Annual/Random and Increase of Capacity inspection to the aforementioned facility. This facility is located on a LAUSD school site. The facility is housed in two separate classrooms in 1 building; classrooms 12 and 13. The facility has submitted an application to increase the facility from 60 school age children to 75 school age children. There is an approved fire clearance on file by Fire Inspector Cindy Struck that was approved on 01/02/2019. Please note, there is a centralized association facility designated to the aforementioned site for staff associations: Facility License #191671712. The classrooms are exempt from measurement requirement per California Code of Regulation 101538.3(c) and Health and Safety Code Section 1596.806 as they are used for instructional use. The outdoor areas to be used by the program is the school playground, including the kindergarten yard. The school perimeter is completely fenced in and there are no bodies of water. There are shade structures and water fountains in the yard. The kindergarten yard has play structure that is age appropriate and has proper cushioning. The following were observed/discussed during this inspection: 1. There are no bodies of water observed on the facility; 2. Fingerprint clearance of staff; 3. Teacher to child ratios; 3. Care and supervision of children in care; teacher/child interaction; 4. Availability of drinking water to children both indoors and outdoor; there are water fountains in the playground areas. 5. Cleanliness of facility and children's toys/equipment; age appropriateness of the children's toys and equipment. 6. Cleanliness of bathrooms, operation of toilets and sinks. 7. Inaccessibility of chemicals and toxins to children in care; (Continued)

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Martha J Vasquez	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA CALABASH CHARTER ACADEMY	FACILITY NUMBER: 197419963
	VISIT DATE: 06/06/2019

NARRATIVE

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8. Quality and quantity of snacks and food for the number of children currently enrolled; storage of food supplies, posting of menus and accuracy.
9. Smoke detector and carbon monoxide detector.
10. Sign in/out sheets; postings; emergency disaster drill logs.

At this time the facility does provide Incidental Medical Services.

The following was thoroughly discussed with the licensee:
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

Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Carrying out medical orders when the child’s physician has determined that a layperson can be trained and safely carry out the orders.

Licensee was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov

Licensee was reminded it is the licensee’s responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations. (Continued)

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Martha J Vasquez	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA CALABASH CHARTER ACADEMY	FACILITY NUMBER: 197419963
	VISIT DATE: 06/06/2019

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 26 27 28 29 30 31 32	Increase of capacity for a total capacity of 75 school-age children is granted effective today 06/06/2019 as requested by the facility. An exit interview was conducted and copy of this report was provided to Rachel Hernandez, Center Director and Ashley Russell, Senior Program Director.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Martha J Vasquez	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019

LIC809 (FAS) - (06/04)

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