376600051-3-14-2023-20-CC-ACAN-CPWKFE-20230314075150

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600051
Report Date: 03/13/2023
Date Signed: 03/14/2023 07:52:36 AM

Document Has Been Signed on 03/14/2023 07:52 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	SOUTH BAY FAMILY YMCA-CHULA VISTA HILLS ELEMENTARY		FACILITY NUMBER:	376600051
ADMINISTRATOR:	BLANCA RINCON		FACILITY TYPE:	840
ADDRESS:	980 BUENA VISTA WAY		TELEPHONE:	(619) 482-7066
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	70	CENSUS: 14	DATE:	03/13/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Blanca Rincon		TIME COMPLETED:	05:30 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 3/13/23, at 2:00 PM, Licensing Program Analyst (LPA) Adrian Castellon, conducted an unannounced annual inspection and met with site supervisor Blanca Rincon. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. This is a before and after school program which operates year round. The morning program operates from 6:00AM to 7:45AM and the afternoon program operates from 2:15PM to 6:00PM. There is currently one classroom in operation (705) . This is a school age program. The following ratios were observed during today's inspection: there were 14 children under the supervision of two qualified staff members. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Most disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children are toxic free. All toilets and handwashing facilities are in safe and sanitary operating condition. All floors in the facility are clean and safe. All food is protected against contamination. Contaminated food is discarded immediately. Drinking water is available both indoors and outdoors. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. The Department has inspection authority as specified in Health & Safety Code.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023

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-CHULA VISTA HILLS ELEMENTARY	FACILITY NUMBER: 376600051
	VISIT DATE: 03/13/2023

NARRATIVE

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A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department.

The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All personnel, including the licensee, administrator and volunteers, shall be in good health and are physically and mentally capable of performing assigned task. Personnel that pose a threat to the health and safety of children shall be relieved of their duties. All personnel are trained on housekeeping and sanitation principles, including universal health precautions or have related experience. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 14 children in care. The licensee ensures children with obvious symptoms related to fever or vomiting are not accepted. The facility is equipped to isolate and care for any child who becomes ill during the day. LPA was able to review a sample of children and staff records.

This facility does provide Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services and has done so. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. No deficiencies cited.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023

LIC809 (FAS) - (06/04)

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