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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016951
Report Date: 08/21/2019
Date Signed: 08/21/2019 11:11:33 AM

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:
08/21/2019
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Angelica CortezTIME COMPLETED:
11:23 AM
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An announced Case Management inspection was conducted by Licensing Program Analyst (LPA), Timothy Fields for the purpose of adding a classroom (bungalow B18) and auditorium to the facility license. LPA met with Senior Program Director Angelica Cortez. In addition to the new space, the cafeteria will remain as usable activity space. The school-age program is located on the campus of Los Cerritos Elementary. Operating hours are from 7:30am - 6:30pm Monday through Friday. Operations is set to begin on 8/28/19.

LPA was informed medication will be administered to children in care. Medication will be stored in a locked cabinet located in bungalow B18. Snacks are stored in the refrigerator and locked cabinet adjacent to the cafeteria. Sick children will be isolated in the cafeteria as well. The program will provide the child with a mat to rest and the adjacent bathroom will be made accessible.

All area identified on the sketch was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. LPA observed age appropriate toys and equipment. LPA was informed additional desks, rugs, and decorations will be added to the activity space in bungalow B18. Lighting was in operable condition. Children's items will be stored on hooks inside the classroom. Drinking water will be made accessible. First aid kits were inventoried.

Children will have access to the elementary playground. There was no swimming pool, spa or other bodies of water observed on the premises. There are drinking fountains adjacent to the playground will be used by children in care. Portable water containers are brought to the playground for children as well. There are gender specific bathrooms available on the elementary site along with two additional bathrooms adjacent to the cafeteria.

Report continued on attached LIC 809C..

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019
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 2
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: YMCA GLB LOS CERRITOS SITE
FACILITY NUMBER: 198016951
VISIT DATE: 08/21/2019
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An approved fire clearance is on file. Licensee is requesting capacity be increased to 130 children. Measurement of the auditorium were obtained during today's inspection. Bunalow B18 is exempted from indoor square footage per Health and Safety Code Section 1596.806. Measurement taken will support the increase requested.

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

An exit interview was conducted with Senior Program Director Angelica Cortez. A copy of the report and notice of site visit will be provided.



Website address to order forms: http://www.dss.cahwnet.gov
INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy FieldsTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019
LIC809 (FAS) - (06/04)
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