198003136-1-10-2023-54-CC-WBIS-CMXSHK-20230110125339

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003136
Report Date: 01/10/2023
Date Signed: 01/10/2023 12:54:10 PM

Document Has Been Signed on 01/10/2023 12:54 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	Y.M.C.A GLB LOS ALTOS		FACILITY NUMBER:	198003136
ADMINISTRATOR:	BRIAN FLORES		FACILITY TYPE:	840
ADDRESS:	1720 BELLFLOWER		TELEPHONE:	(562) 596-3394
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90815
CAPACITY:	70	CENSUS: 0	DATE:	01/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:38 AM
MET WITH:	Sammy Brittain/Aileen Tapia		TIME COMPLETED:	01:05 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) Warren Birks conducted an unannounced Required 1 year inspection. LPA met with Senior Program Director Sammy Brittain and Site Director Aileen Tapia who guided analyst on tour of the facility. This is a school-age program that operates morning and afternoon sessions Monday through Friday from 6:30am to 9:00am and 1:30pm to 6:00pm. Transportation services are provided.

The school age program operates on the same premises as a YMCA membership facility. The two classrooms and outdoor activity space are completely separate with the exception of a shared activity room. The YMCA members use the shared activity room during non school age hours. Children and parents enter the facility through a back entrance and sign in. LPA observed the following: Modular 1 Room and and Modular 2 Room both with zero teachers and zero students as the afternoon program was not in session (Begins at 1:30pm).

Physical Plant. Furniture and equipment was inspected for age appropriateness and good repair free of sharp, loose, or pointed parts. Floors are clean and safe. Disinfectants, cleaning solutions are kept in a storage room inaccessible to children Note: Any Poisons shall be kept locked. The primary lighting source is overhead lighting. The facility has central air/heating. Electrical outlets are covered in the classrooms. The facility uses a water dispenser in the classrooms for children to drink as they wish. LPA observed a swimming pool which belongs to the membership facility. The pool is out of view of the children and has a self latching, self closing gate that swings away. LPA strongly advised to provide 100% supervision if children on occasion have to walk through areas where the pool is in view.

Restrooms have a single stall and are clean and odor free. There is an adequate supply of toilet paper, paper towels, and soap. All restroom fixtures are height appropriate for children. Staff have their own restroom located near the office. The isolation area for ill children is located in the school age office area. A mat is available if necessary and children use the staff bathroom if ill.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

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 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: Y.M.C.A GLB LOS ALTOS	FACILITY NUMBER: 198003136
	VISIT DATE: 01/10/2023

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

The facility serves lunch and an afternoon snack. A morning snack is available if needed. The kitchen and snack area appear to be safe and sanitary. There is an adequate amount of food items and LPA observed some food items with the expiration dates. Other individual items did list an expiration date. LPA advised staff to have vendors list expiration dates. Menus were reviewed. Trash bins to discard food have tight fitting lids.

Outdoor activity play area is comprised of concrete (no climbing equipment). During outdoor activities, water dispensers and cups are provided for children to drink. The area is surrounded by a fence that is at least 5 feet high and has a canopy for shade. LPA advised 100% supervision as the facility operates on the grounds of a YMCA membership facility which has a pool.

FACILITY RECORDS All staff present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid (expires 2024).

Teacher child ratios were observed and staff names recorded. The facility uses sign in and out sheets. In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of authorized representatives who can assume responsibility for the child. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Menus are posted at least one week in advance where it is visible by the child's authorized representative. Snack servings on menus were reviewed quantity and appropriateness to children in care. Staff records were reviewed for completeness. Staff and children's records are digital.

Medication policy is as follows: Facility administers prescription medication only. An authorization form must completed by parent and the same form is completed by staff once medication administered. All medications must be in its original containers. All Medications are kept in the closet room in a locked box. First Aid supplies are available. 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 at: www.ada.gov/childqanda.htm.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: Y.M.C.A GLB LOS ALTOS	FACILITY NUMBER: 198003136
	VISIT DATE: 01/10/2023

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

Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Effective January 1, 2018: Existing licensees must meet requirements by March 30, 2018. Preventive (OCAP) online training modules are free of cost and available at http://www.mandatedreporterca.com/. All employees have completed the required Mandated Reporter Training.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

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 reprehensive. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Senior Program Director Sammy Brittain and Site Director Aileen Tapia.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3