376600552-1-26-2023-51-CC-PMAA-CNG4V6-20230126182548

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600552
Report Date: 01/26/2023
Date Signed: 01/26/2023 06:25:54 PM

Document Has Been Signed on 01/26/2023 06:25 PM - 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:	MISSION VALLEY YMCA - BAY PARK ELEMENTARY SCH. AGE		FACILITY NUMBER:	376600552
ADMINISTRATOR:	MELANIE WAYMIRE		FACILITY TYPE:	840
ADDRESS:	2433 DENVER STREET		TELEPHONE:	(619) 298-3576
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY:	125	CENSUS: 59	DATE:	01/26/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Dayna Whitty		TIME COMPLETED:	06:40 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 1/26/23 at 3:00pm, Licensing Program Analyst, Patrick Ma, met with Site Supervisor for the purpose of an unannounced annual inspection. There were 59 children present with 6 teachers in one room and outside playground. Facility is within ratio and capacity. Program operates Monday, Tuesday, Thursday, and Friday from 3:30 – 6pm and 1 – 6pm on Wednesdays. The program operates in B-23, 20, the auditorium and cafeteria. The children were observed to be under visual supervision. LPA toured the facility. The rooms were clean, orderly and a comfortable temperature during this visit. Adequate ventilation and heating are available. The furniture, books, games and toys are safe, age-appropriate and in good repair. There is a variety of activities available. All required forms were posted. The snack menu is posted, changes are recorded, and menus are stored for 30 days. Food has been stored separately from any chemicals or cleaning products. Drinking water is readily available. Hand washing and toileting areas are in a safe, sanitary and operating condition. Medications are kept in a locked cabinet, inaccessible to children. Poisons, disinfectants, cleaning solutions and other items that are dangerous to children have been made inaccessible. There is no evidence of rodent or insect activity. Outdoor play area is shared with the elementary school and has sufficient cushioning and adequate shade. Age appropriate playground equipment and outdoor surfaces are in a safe condition with equipment securely bolted to the ground. Outdoor facets are available to children. There are no bodies of water, firearms or ammunition on the property. The carbon monoxide detector is operational. The facility has a written disaster plan in place that meets regulatory requirement and has been conducting and documenting evacuation drills every six months. The facility does not transport children.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

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: MISSION VALLEY YMCA - BAY PARK ELEMENTARY SCH. AGE	FACILITY NUMBER: 376600552
	VISIT DATE: 01/26/2023

NARRATIVE

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LPA reviewed sign in/out sheets, a sample of personnel records and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.

Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is outside by the office with a supervising staff or inside room 23 away from other children

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 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/are not in place today

Facility representative 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.
Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

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: MISSION VALLEY YMCA - BAY PARK ELEMENTARY SCH. AGE	FACILITY NUMBER: 376600552
	VISIT DATE: 01/26/2023

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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

No deficiencies are cited. See Technical violations attached.

Exit interview conducted and report was reviewed with the facility representative Dayna Whitty. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

LIC809 (FAS) - (06/04)

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