360907960-5-10-2023-09-CC-RZEN-CRNPE2-20230509111425

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360907960
Report Date: 05/08/2023
Date Signed: 05/10/2023 10:33:50 AM

Document Has Been Signed on 05/10/2023 10:33 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	CHINO FAMILY YMCA - GIRD SITE		FACILITY NUMBER:	360907960
ADMINISTRATOR:	RUIZ,AMY		FACILITY TYPE:	840
ADDRESS:	4980 RIVERSIDE DRIVE		TELEPHONE:	(909) 590-3583
CITY:	CHINO	STATE: CA	ZIP CODE:	91710
CAPACITY:	80	CENSUS: 0	DATE:	05/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sandra Robles- Childcare Director, Jillian Johnson - Director and Justine Gomez - Childcare coordinatior		TIME COMPLETED:	11:30 AM

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), Rachel Zeron conducted an announced visit to return the facility back to an active status and conduct an annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted: Hours of operation: Monday- Friday 6:30am - 6:30pm · The following were posted and are updated where necessary: - License - Emergency Disaster Plan (LIC610) and Earthquake Preparedness Checklist (LIC9148) - Parent’s Rights Poster (PUB393) - Personal Rights (LIC613A) - Child Car Seat Law - Menu ( will send current · The facility is operating with the limits as stated on the license · Ratios are being met during this inspection · Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards · There are no weapons present at the facility as stated by Sandra Robles · There are no accessible bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position. · Drinking water is provided in the indoor activity space and in the outdoor activity space by water bottles brought by children and filtered water. · Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous · Poisons and toxins are locked · All floors are clean and safe

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHINO FAMILY YMCA - GIRD SITE	FACILITY NUMBER: 360907960
	VISIT DATE: 05/08/2023

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
26
27
28
29
30
31
32

· Bathrooms were observed to be safe, sanitary and in operating condition
· Playgrounds are enclosed by appropriate fencing and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Food preparation area is clean, free of litter and rubbish and free of rodents and other vermin
· Food is stored appropriately and protected from contamination
· Sign in/Sign out record was reviewed and meets regulation requirements
· Disaster drills are conducted at least every six months – facility has been inactive since 2020, Director will conduct a drill the first week of care.
A review of staff and children's records were conducted as part of this evaluation.
· Children’s records were found to be complete during this inspection.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 08/2024
· Opening and closing staff member’s CPR/First Aid expires on 12/2024 and 06/2024
· Director completed Health and Safety Training
· A review of staff records indicates that all staff present meet minimum qualifications for the position for which they were hired.
· A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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

The following items were discussed with the Director during inspection:

· Menus shall be posted at least one week in advance in a place visible by the child’s authorized representative, dated and kept on file for 30 days, and made available upon request.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHINO FAMILY YMCA - GIRD SITE	FACILITY NUMBER: 360907960
	VISIT DATE: 05/08/2023

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
26
27
28
29
30
31
32

· The Licensee was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov
Licensee 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.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200
The licensee/director is asked to update the following documents, if applicable, and submit to licensing within 30 days:
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made or file copy is more than 2 years old)
4. LIC 309 Administrative Organization (only if changes have been made or file copy is more than 2 years old)
5. LIC 308 Designation of Administrative Responsibility (only if changes have been made& current designation is on file)
There are no deficiencies being cited at this time. The site is set to reopen on 05/30/2023, LPA Zeron approved the facility to return to active status and will send an updated license prior to opening.
An exit interview was conducted, and this report was reviewed with Sandra Robles, Childcare Director. Appeal rights were discussed and provided during the exit interview.
A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3