370806125-11-9-2021-20-CC-JGAY-C8ZQTP-20211122112724

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370806125
Report Date: 11/09/2021
Date Signed: 11/09/2021 04:10:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/24/2021 and conducted by Evaluator Luigi Gargaro

COMPLAINT CONTROL NUMBER: 20-CC-20210824161731

FACILITY NAME:	SOUTH BAY FAMILY YMCA - EASTLAKE ELEMENTARY		FACILITY NUMBER:	370806125
ADMINISTRATOR:	MARASIGAN,MONIQUE		FACILITY TYPE:	840
ADDRESS:	1955 HILLSIDE DRIVE		TELEPHONE:	(619) 421-4798
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91913
CAPACITY:	70	CENSUS: 5	DATE:	11/09/2021
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Site Supervisor Monique Marasigan		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff refused to accept physician's notes regarding child's prescription medication.

INVESTIGATION FINDINGS:

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On 11/09/21 at 3:30PM, LPA, Luigi Gargaro, conducted an unannounced complaint visit with facility site supervisor, Monique Marasigan, today to deliver the finding for the above listed allegation. During the course of the investigation, analyst conducted interviews with the site supervisor, child in question (child #1), child’s parent and child’s elementary school classroom teacher. Analyst also reviewed program’s medical documentation and submission requirement policies as well as alternatively submitted medical documentation for the child.

Based on the information gathered, analyst determined that the program site supervisor did decline to accept what day care parent submitted as medical information required to allow her child to be enrolled in the program. However, while the program clearly indicates in its parent handbook what that the required documentation is, it does not document parents’ receipt of the handbook or whether any type of reasonable substitute medical documents may be accepted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

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

LIC9099 (FAS) - (06/04)

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Control Number 20-CC-20210824161731

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 - EASTLAKE ELEMENTARY	FACILITY NUMBER: 370806125
	VISIT DATE: 11/09/2021

NARRATIVE

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It could not therefore be conclusively proved or disproved whether the facility had a valid basis for denying a physician’s note regarding a child’s medication Though the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Appeal Rights (1/16) were discussed. A copy of the report, appeal rights and a Notice Of Site Visit, to be posted for 30 days, were printed and provided to the site supervisor today. No deficiencies were cited.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

LIC9099 (FAS) - (06/04)

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