198017013-10-17-2024-54-CC-AMOY-DA5TWU-20241017150606

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017013
Report Date: 10/17/2024
Date Signed: 10/17/2024 03:06:21 PM

Document Has Been Signed on 10/17/2024 03:06 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:	YMCA GLB LOS CERRITOS		FACILITY NUMBER:	198017013
ADMINISTRATOR/ DIRECTOR:	MICHELE JANSSEN		FACILITY TYPE:	840
ADDRESS:	15530 WOODRUFF AVENUE		TELEPHONE:	(562) 925-1292
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY: 80	TOTAL ENROLLED CHILDREN: 80	CENSUS: 0	DATE:	10/17/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Michele Janssen, Facility Representative		TIME VISIT/ INSPECTION COMPLETED:	01:30 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced annual required inspection at the above facility. LPA met with Director Michelle Janssen, who guided analyst on a tour of the facility. Per Director, operation days/hours are Monday thru Friday with a morning and afternoon schedule. Children come to the facility from 6:30 AM- 9:00 AM before school and after school children come in from 1:30 PM- 6:00 PM.
The facility has four classrooms and a gym (Reading Room, Adventure Room Fellowship room, Computer lab, Science Center, gym room) where care is provided. LPAs observed no children at the time of inspection. The following was observed during the tour of the facility:

LPA toured classrooms. All classrooms were observed to be clean and in good repair. The floors were clean and lighting was in operable condition. There were age appropriate supplies, toys and equipment. Per Director, children use the drinking fountain/ water dispenser located in the hallway. Each child brings their own drinking water which is labeled with their names. LPA observed cubbies/storage area for children to store their personal belongings.

Smoke detector and carbon monoxide detector were observed to be in operable condition. LPA observed fire extinguisher indicated fully charged last serviced on 4/1/24. First Aid kit was observed and inventoried.

Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, and general sanitation. Disinfectants and cleaning solutions were observed to be inaccessible to children in care. Per Director, there are no poisons stored at the facility.

Per Director, the isolation area is located in the hallway between the Directors office and the reception desk and can use the staff restroom if needed. Per Director, no children enrolled require medication. LPA observed a locked empty medicine cabinet in the Directors office inaccessible to children in care. Children do not nap at facility

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024

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

FACILITY NAME: YMCA GLB LOS CERRITOS	FACILITY NUMBER: 198017013
	VISIT DATE: 10/17/2024

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LPA toured the outdoor play area. Outdoor area was observed to have age-appropriate toys and material for children, free of loose, sharp, and/or pointed parts. LPA observed required cushioning under climbing structure to absorb a fall including wood chips. LPA advised Facility Representative to inspect the ground to ensure there are no hazards or animal droppings.

Required shade was observed in the outdoor area. LPA observed a water fountain and water dispenser in the outdoor area that is accessible for children. Per Director children bring their own water bottles from home and use the water dispenser if needed. Cups are also provided to children if needed. LPA observed no bodies of water on the premises.

LPA observed the kitchen area, food preparation area, and food storage area to be clean and free of litter, rubbish, rodents, and/or any other vermin. Per Director, food is provided by the school district daily. LPA observed refrigerator to be clean and in operable condition. LPA observed items in the refrigerator not to be expired. LPA reviewed a current Children's roster.

LPA observed required posted documentation which included, Facility License, LIC610- Emergency Disaster Plan, Publication (PUB) 393- Notification of Parent Rights, PUB 269- Child Passenger Restraint System, LIC 613A- Notification of Personal Rights and Lunch/Snack Menus. All documents were observed in a prominent, publicly accessible area of the facility.

LPA observed Sign in/out sheets, LIC 9148 Earthquake Preparedness, Daily Activity Schedule, and Verification of Disaster and Fire Drills. Director was advised that children should be signed in and out daily by authorized representative.

Children’s records were reviewed for LIC 613A- Personal Rights, Admission Agreement, Immunization Records, LIC 700- Identification and Emergency Information, LIC 701- Physician’s Report, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights. All records were observed to be complete.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, staff qualifications, LIC 508-Criminal Record Statement, LIC 503- Health Screening Report, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, and LIC 9108- Statement of Child and Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024

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

FACILITY NAME: YMCA GLB LOS CERRITOS	FACILITY NUMBER: 198017013
	VISIT DATE: 10/17/2024

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S3 did not have the current mandated reporter training certificate at the time of inspection. Director was advised that mandated reporter training should be taken every two years.

Lead Testing was conducted on 12/29/22 for water sources used for drinking and meal prepping. Lead testing report shows no lead exceedance.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Based on the LPA’s observation and record review 1 "B" deficiencies will be cited today.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview was conducted and report was reviewed with the Director. Appeal rights were discussed and provided to Director.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/17/2024 03:06 PM - It Cannot Be Edited

Created By: Alicia Mooberry On 10/17/2024 at 12:13 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: YMCA GLB LOS CERRITOS	FACILITY NUMBER: 198017013
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that Staff #3 did not have a current Mandated Reporter Certifciate on file which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/24/2024
	Plan of Correction
1 2 3 4	Per Director, the Mandated Reporter training will be competed and the certificate will be sent to LPA via email by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Valarie Cook

LICENSING EVALUATOR NAME:

Alicia Mooberry

LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024

LIC809 (FAS) - (06/04)

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