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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334803473
Report Date: 07/02/2019
Date Signed: 07/02/2019 12:53:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:DESERT YMCA/JEAN M. BENSON CDCFACILITY NUMBER:
334803473
ADMINISTRATOR:ROBIN MCCONNELLFACILITY TYPE:
850
ADDRESS:75-433 ORANGE BLOSSOMTELEPHONE:
(760) 836-3336
CITY:PALM DESERTSTATE: CAZIP CODE:
92211
CAPACITY:101CENSUS: 55DATE:
07/02/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Robin McConnellTIME COMPLETED:
01:00 PM
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LPAs, Joanne Domingo, LaKesha Edwards and Otsanya Cameron arrived at the facility on a case management visit to follow-up on an unusual incident report submitted by the facility on 6/24/19. At the time of visit, LPAs toured the facility, took census, reviewed records, video tape footage, and met with Director - Robin McConnell to discuss the reported incident. The incident occurred on 6/12/19 during nap-time, however the memory/storage of the video recording for 6/12/19 had expired. LPAs were able to view other dates of nap-time that can corroborate the child's behavior during nap-time. LPAs also observed the child at nap-time during the visit. LPAs also spoke with the Teacher who witnessed the incident as it took place. The subject child involved in the incident was interviewed by the LPAs as well.
Based on the information obtained during the visit, there appeared to be no violations of Title 22 Regulations pertaining to the reported incident.

An exit interview was held with Director - Robin McConnell. A Notice of Site visit was issued, along with a copy of this report. This report shall be public record for three years.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Joanne DomingoTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
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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