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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493624
Report Date: 01/22/2020
Date Signed: 01/23/2020 10:03:48 AM

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 HAMLIN CHARTER ACADEMYFACILITY NUMBER:
197493624
ADMINISTRATOR:JEFFERSON, CHRISTOPHERFACILITY TYPE:
840
ADDRESS:22627 HAMLIN STREETTELEPHONE:
(818) 774-2840
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY:40CENSUS: 0DATE:
01/22/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Mayra HernandezTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA), V. Wheatley conducted a case management inspection regarding an incident that occurred on December 19, 2019 whereby Child #1 urinated on a tree outside during day care hours.

LPA met with Site Director Mayra Hernandez at 12:30pm. The program is a before and after school program for school aged children. The children are not on the premises at this time, however Ms. Hernandez was able to be interviewed regarding the incident. LPA also interviewed Adult #1 who verified the incident occurred. Child #1 made the decision to urinate on a tree on the playground instead of using the restroom.

LPA inspected the outdoor play area and did not observe any hazards or unsafe equipment. The play area is located right outside the classroom. It is unclear why the child conducted inappropriate behavior as the restroom is very close to the outdoor play area and classroom. Since the incident occurred the children have been reminded about restroom procedures and the children are not allowed to play near the trees.

Based on observations, interviews conducted, and information obtained there are no deficiencies. The Child #1 was supervised by Staff #1.

Exit interview. A copy of this report was provided.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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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