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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016951
Report Date: 08/02/2019
Date Signed: 08/02/2019 01:45:07 PM

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:YMCA GLB LOS CERRITOS SITEFACILITY NUMBER:
198016951
ADMINISTRATOR:ALYSHA RODRIGUEZFACILITY TYPE:
840
ADDRESS:515 WEST SAN ANTONIO DRIVETELEPHONE:
(562) 279-1700
CITY:LONG BEACH, CA 90807STATE: CAZIP CODE:
90807
CAPACITY:58CENSUS: 0DATE:
08/02/2019
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Angelica CortezTIME COMPLETED:
01:50 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an announced case management inspection to view a prospective classroom and additional indoor space (auditorium). The facility is requesting indoor space changes as two classes will no longer be used and two indoor spaces have become available. LPA Birks met with Director Angelica Cortez who gave a tour of the facility. This is a school age program currently licensed for 58 children. The program is closed for the Summer.

As a courtesy LPA observed and measured one new classroom, the cafeteria and the auditorium space. LPA informed Director of the following:

The heater in the classroom will need to be made inaccessible.
All space not utilized by children will be taken out of classroom space.
Hazards or potential hazards in the auditorium stage area (such as open wire panels) must be inaccessible.
Any stored items on the stage will be taken out of measured space.
Any change in the use of space must be reported to Licensing as it may affect safety and/or capacity.

The measurements for the indoor space has a capacity of 100+ children however, Director Cortez indicated that she is only requesting space to be approved and not capacity increase at this time. Director Cortez indicated she may request an increase at a later date. Director Cortez indicated that all rooms will be cleaned before use.

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 Director Angelica Cortez.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019
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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