370805284-11-2-2020-20-CC-RGOU-BUYT29-20201102132022

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370805284
Report Date: 11/02/2020
Date Signed: 11/02/2020 01:20:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	SOUTH BAY FAMILY YMCA - ROSEBANK ELEMENTARY		FACILITY NUMBER:	370805284
ADMINISTRATOR:	JULIE ARTEAGA		FACILITY TYPE:	840
ADDRESS:	80 FLOWER STREET		TELEPHONE:	(619) 422-8329
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	56	CENSUS: 22	DATE:	11/02/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:28 PM
MET WITH:	Gillian Gorelik		TIME COMPLETED:	01:30 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	On 11/02/20 at 12:28 p.m., Licensing Program Analyst (LPA), Rajani Goudreau arrived at the facility to conduct a Case Management – Licensee Initiated inspection for the purpose of a capacity increase. Upon arrival LPA, met with Program Director, Gillian Gorelik and Director, Julie Artega and proceeded to tour the facility. There were 22 children in care at time of visit. The facility is requesting a capacity increase of 70 school age children, serving ages transitional kindergarten through 12 years old. This school-age program will operate at Rosebank Elementary in the following classrooms: #901, Multi-Purpose room and the Library. Facility operates Monday through Friday from 7:00 a.m. to 4:30 p.m. Facility is exempt from square footage, toilet, isolation space, outdoor activity space, and fencing requirements, per, H&S 1596.806. The classrooms are equipped with appropriate furniture; including tables, chairs, bookshelves, and other materials for the use of children. There is a functioning carbon monoxide detector located in classroom #901 and a first aid kit with required supplies. Disinfectants, cleaning solutions, and other hazardous substances shall be kept inaccessible. Drinking water is available in the classrooms via water pitchers. The school provides Breakfast and Lunch. Required documents are posted in classroom #901. The facility will be utilizing boy's and girl's restrooms located near the #300 and #400 buildings. Also, will be utilizing boy’s and girl’s restrooms near the #500 and #600 buildings. Children are to be escorted and supervised by staff to and from the restrooms. The outdoor activity space consists of a black top area and grass area located near the side of the school and another black top area in the front of classroom #901. Children will utilize the outdoor lunch area near the MPR room for eating and during outdoor activities. Shaded rest areas consist of tree's and Gazebo's. The surface of the outdoor activity space is observed to be free of hazards. Drinking water is readily available out in the play area via water pitchers. Discussed proper supervision and placement of staff during outdoor activities to ensure the safety of children at all times. See LIC809-C continuation page…

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2020

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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SOUTH BAY FAMILY YMCA - ROSEBANK ELEMENTARY	FACILITY NUMBER: 370805284
	VISIT DATE: 11/02/2020

NARRATIVE

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Facility currently has exclusive use of the outdoor play areas as the school is currently closed due to COVID-19. LPA indicated an updated plan of operation to ensure supervision is in place and exclusive use of the classrooms and activity spaces during indoor and outdoor activities shall be submitted to the department once the school opens for in-person instruction.

This facility provides Incidental Medical Services - IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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. Services are in place. LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

A fire clearance for 70 school aged children was granted on October 09, 2020. Letter from the School District dated August 24, 2020 approving use of the classrooms is on file.

No deficiencies issued during today's visit. LPA conducted an exit interview with Gillian Gorelik. LPA discussed and provided the following: LIC809, LIC809-C, LIC9213-Notice of Site Visit and Appeal Rights. Notice of Site Visit shall be posted for 30 days from today's date. LPA observed Notice of Site Visit posted prior to exiting facility. A capacity increase of 70 school age children ages K-12 years old shall be granted after final file review.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2020

LIC809 (FAS) - (06/04)

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