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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019117
Report Date: 11/16/2022
Date Signed: 11/16/2022 03:08:53 PM


Document Has Been Signed on 11/16/2022 03:08 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:YMCA OF GREATER WHITTIERFACILITY NUMBER:
198019117
ADMINISTRATOR:NICOLE RODRIGUEZFACILITY TYPE:
850
ADDRESS:12510 HADLEY ST.TELEPHONE:
(562) 392-6119
CITY:WHITTIERSTATE: CAZIP CODE:
90601
CAPACITY:42CENSUS: 6DATE:
11/16/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Director, Nicole RodriguezTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) conducted an unannounced POC (plan of correction) inspection to ensure that the Type B deficiency cited on 11/3/22 has been cleared. LPA met with Director, Nicole Rodriguez to whom the reason for the visit was explained. A COVID risk assessment was conducted upon entry and appropriate PPE was used.

LPA toured the facility. The following was observed:

Preschool room contained 1 teacher and 6 children. Teacher-Child Ratio was met with qualified staff.

LPA obtained meeting agenda from 11/11/22 with ratio/commingling listed as an agenda topic and meeting sign-in sheets.

LPA cleared deficiency on this date and provided a copy of the Licensing Report to Nicole Rodriguez, Director. LPA issued POC clearance letter during the visit.

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

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 Director, Nicole Rodriguez.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Lilli BabcockTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2022
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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