304270062-3-4-2025-06-CC-MMAK-DEFVKF-20250304153017

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270062
Report Date: 03/04/2025
Date Signed: 03/04/2025 03:30:26 PM

Document Has Been Signed on 03/04/2025 03:30 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	SOUTH COAST YMCA-HIDDEN HILLS		FACILITY NUMBER:	304270062
ADMINISTRATOR/ DIRECTOR:	CHACON, JUSTINE		FACILITY TYPE:	840
ADDRESS:	25142 HIDDEN HILLS ROAD		TELEPHONE:	(949) 249-6110
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 90	CENSUS: 46	DATE:	03/04/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:30 PM
MET WITH:	Site Supervisor, Justine Chacon		TIME VISIT/ INSPECTION 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	Page 1 of 3 Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite inspection for the purpose of an Annual Inspection. LPA met with director Justine Chacon in P2 (Y2) classroom. There were no children in P1 (Y1) and P2 (Y2) classrooms at the time of LPA's arrival. LPA observed 46 school age children were outdoor with 4 staff getting ready to arrive in portables. LPA toured the facility inside and outside. During the inspection it was determined the facility is operating within its licensed capacity and not within compliance of staffing ratios. Facility hours are 6:45 a.m.- 6:00 p.m., Monday through Friday. Parents sign their children in and out electronically. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During the inspection of the indoor activity space, items which could pose a danger to children (cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. The facility provides morning, afternoon snacks to children. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. Drinking water is available to children indoors by water containers that children bring from home and the facility fill them up with filtered water. There are no sinks inside the rooms. Children wash their hands in the sinks located in the restrooms located on the elementary ground. The facility has conducted an emergency drill within the past six months, last drill was in 2/7/2025. The facility has a working carbon monoxide detector mounted on the wall. Facility met all posting requirement. The outdoor activity space was inspected for compliance. The playground on the elementary site is for children's use and it is all fenced. The surface of the outdoor activity space was well maintained and free of hazards. The cushioning material under and around the climbing equipment Continue to page 2

Thuy Ho	TELEPHONE: (714) 703-2741
Mahnaz Malek	TELEPHONE: (714) 292-9851
	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SOUTH COAST YMCA-HIDDEN HILLS	FACILITY NUMBER: 304270062
	VISIT DATE: 03/04/2025

NARRATIVE

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such as slides appeared to be enough to absorb falls. Drinking water in the outdoor activity space is provided by water containers children brought from home and the facility fills them up by filtered water if needed. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility.
Staff files were reviewed for staff present during the facility inspection on this date, 4 staff files were reviewed. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a childcare center if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for staff were reviewed and were in compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications which are in compliance.
Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of 5 children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in full compliance.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care
Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was not completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. However the facility is using drinking filtered water from water dispenser from a private water company. There are no sinks in the rooms for drinking or food preparation. The facility representative was provided a copy of lead testing from the water company that showed no sign of lead. Facility has submitted attestation to Orange County Office for this purpose and has granted the approval of being exempt from lead water testing. .
LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian
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SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SOUTH COAST YMCA-HIDDEN HILLS	FACILITY NUMBER: 304270062
	VISIT DATE: 03/04/2025

NARRATIVE

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For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301(voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at:https://www.ada.gov/resources/child-carecenters.
The director Justin Chacon was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communications. The director Justine Chacon was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website atwww.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 on this inspection. A notice of site visit was given to director Justine Chacon and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to post will result in Civil Penalties of $100.00. Exit interview conducted and report was reviewed with the director Justine Chacon.

End of report.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

LIC809 (FAS) - (06/04)

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