376700048-7-29-2021-20-CC-DSAZ-C5DTQQ-20210729145620

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700048
Report Date: 07/29/2021
Date Signed: 07/29/2021 02:56:27 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 - LIBERTY ELEMENTARY SCHOOL		FACILITY NUMBER:	376700048
ADMINISTRATOR:	FATIMA CIFUENTES		FACILITY TYPE:	840
ADDRESS:	2175 PROCTOR VALLEY ROAD		TELEPHONE:	(619) 397-5225
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91914
CAPACITY:	98	CENSUS: 28	DATE:	07/29/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Jennifer Saldana, Site Supervisor		TIME COMPLETED:	03:00 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 7/29/2021, at 2:00 p.m., Licensing Program Analyst (LPA) D. Sanchez, conducted an unannounced Annual Inspection and met with Site Supervisor, Jennifer Saldana. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. This is an AM/PM half day program which operates year around. Facility operates before and after school. There are currently 3 classrooms in operation, room 406, 607 & Multi-Purpose Room. There were 28 children present with three 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. 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 hand washing facilities are in safe and sanitary operating condition. All floors in the facility are clean and safe. Facility does not provides lunch only AM or PM snacks. Lunch is provided by school cafeteria. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Facility does not use school playground equipment. They only use the black top area for outside activities. 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. 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.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

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 - LIBERTY ELEMENTARY SCHOOL	FACILITY NUMBER: 376700048
	VISIT DATE: 07/29/2021

NARRATIVE

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Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. 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 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. 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. Menus are posted at least one week in advance where an authorized representative can view them.
This facility provides 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. 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.

LPA and Jennifer discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts, Forms and Regulations.
Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited. An exit interview was conducted with Jennifer Saldana.
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.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

LIC809 (FAS) - (06/04)

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