198017224-6-17-2022-54-CC-ECHZ-CFGUNL-20220617154407

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017224
Report Date: 06/17/2022
Date Signed: 06/17/2022 03:44:22 PM

Document Has Been Signed on 06/17/2022 03:44 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:	SOUTHEAST RIO VISTA YMCA-RIO VISTA PRESCHOOL		FACILITY NUMBER:	198017224
ADMINISTRATOR:	LORENA CASTRO		FACILITY TYPE:	850
ADDRESS:	3355 GAGE AVENUE		TELEPHONE:	(323) 585-4802
CITY:	HUNTINGTON PARK	STATE: CA	ZIP CODE:	90255
CAPACITY:	58	CENSUS: 18	DATE:	06/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:			TIME COMPLETED:	04:00 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) Elka Chavez conducted an unannounced required 1-year inspection. Facility is currently licensed for a capacity of 58 children. Licensing staff met with Teacher Veronica Alvarado as Director Lorena Castro was unavailable. The program currently operates a morning and an afternoon session Monday thru Friday from 7:30 AM to 4:30 PM. At 1:00 PM LPA was taken on a guided tour of the facility of both indoors and outdoors by Teacher Veronica Alvarado. All areas identified on the facility sketch were inspected. Upon arrival, LPA observed 17 children with 2 staff. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The facility is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times. The following was observed during tour of facility: Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. The indoor of the classroom was inspected to ensure that the floors have a surface that is safe and clean. LPA observed all toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, the Director’s office is used as the designated ill isolation area. Parents are contacted immediately when children are determined to be ill. Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility does not provide lunch. LPA Chavez observed all kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to children. LPA observed they are kept under the sink with a child safety latch. Storage areas for poisons are locked. Facility has one or more

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

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: SOUTHEAST RIO VISTA YMCA-RIO VISTA PRESCHOOL	FACILITY NUMBER: 198017224
	VISIT DATE: 06/17/2022

NARRATIVE

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functioning carbon monoxide detectors that meet requirements. And fire extinguisher was last serviced on March 2022.

At 1:20 PM LPA Chavez observed outdoor activity space equipment and surface is maintained in a safe condition as is free of hazards. Areas around and/or under climbing equipment and slides have cushioning material to absorb a fall. The facility representative states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit.

At 1:30 PM sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file.

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

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.

Facility representative, Veronica Alvarado 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.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

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: SOUTHEAST RIO VISTA YMCA-RIO VISTA PRESCHOOL	FACILITY NUMBER: 198017224
	VISIT DATE: 06/17/2022

NARRATIVE

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There were no deficiencies cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative, Veronica Alvarado.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

LIC809 (FAS) - (06/04)

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