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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600186
Report Date: 10/25/2024
Date Signed: 10/26/2024 08:10:56 AM


Document Has Been Signed on 10/26/2024 08:10 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 - OLYMPICVIEW ELEMENTARYFACILITY NUMBER:
376600186
ADMINISTRATOR:ROSIE VAZQUEZ-MARESFACILITY TYPE:
840
ADDRESS:1220 SOUTH GREENSVIEW DRIVETELEPHONE:
(619) 656-2030
CITY:CHULA VISTASTATE: CAZIP CODE:
91915
CAPACITY:60CENSUS: 25DATE:
10/25/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Genesis EscobedoTIME COMPLETED:
02:45 PM
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On 10/25/2024 at 1:55 p.m. Licensing Program Analyst, Cindy Meier conducted an unannounced annual inspection and met with Facility Representative, Youth Development Teacher, Genesis Escobedor. LPA disclosed the purpose of the inspection and toured the inside and outside of the facility. This is a full day program that operates year-round. Days and hours of operation are Monday – Friday, 6:00 a.m. – 6:00 p.m. There is one classroom in operation. The following ratios were observed: twenty five (25) children with three (3) staff members.

Furniture and equipment in the classrooms were observed to be in good condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space and playground equipment is maintained, is in safe condition and is free of hazards. There is sufficient cushioning to absorb falls under and around play equipment. The playground area includes a shaded rest area for children through the use of canopies and trees.

Toilet and handwashing equipment are in safe and sanitary operating condition. Floors in the facility are clean and safe. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Facility has a functioning carbon monoxide detector that meets statutory requirements. The last fire/disaster drill was conducted and documented on 8/7/24. The facility provides snacks. Food preparation areas are clean and safe. Notation of children’s allergies is accessible. All food is protected against contamination and any contaminated food is discarded immediately.

Facility Representative, Youth Development Teacher stated there are no bodies of water or on the premises and LPA did not observe any bodies of water. Facility Representative, Youth Development Teacher stated there are no firearms, weapons, or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible to children. No poisons were observed during the inspection.

SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Cindy MeierTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 - OLYMPICVIEW ELEMENTARY
FACILITY NUMBER: 376600186
VISIT DATE: 10/25/2024
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A review of staff records on this date indicates facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.

Facility Representative, Youth Development Teacher was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.



All required notices, forms and license(s) were posted. Capacity and limitations as specified on the license are being maintained. At least one person trained in EMSA approved Pediatric CPR and First Aid is present when children are at the facility or at offsite activities. The name of the childcare center director or fully qualified teacher, designated to act in the director’s absence, has been reported to the Department. Children are under supervision, including visual supervision, of a teacher at all times. The person who signs the child in/out of the facility shall use their full signature and record the time of day. Sign in/out sheets reviewed and observed by the LPA meet this regulation. Facility maintains a ratio of one teacher supervising no more than 14 children in care. All required documentation is completed and was reviewed.

LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment.

LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis, and measles, and current documentation of completed mandated reporter training.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.


For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Cindy MeierTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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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 - OLYMPICVIEW ELEMENTARY
FACILITY NUMBER: 376600186
VISIT DATE: 10/25/2024
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Facility Representative, Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA and Facility Representative, Director discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Forms and Regulations, Lead Poisoning Facts, Guardian and California Megan’s Law (www.meganslaw.ca.gov).

LPA and Facility Representative, Youth Development Teacher discussed the Community Care Licensing website www.ccld.ca.gov which will provide access California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts and PIN 21-21-CCP: Lead Testing of Water in Licensed Child Care Centers Per AB 2370, Forms and Regulations.



Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies were cited.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days.


Exit interview conducted and report was reviewed with the Facility Representative, Youth Development Teacher, Genesis Escobedor.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Cindy MeierTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC809 (FAS) - (06/04)
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