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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700049
Report Date: 10/21/2020
Date Signed: 10/21/2020 02:16:38 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 - SALT CREEK ELEMENTARYFACILITY NUMBER:
376700049
ADMINISTRATOR:GILLIAN GORELIKFACILITY TYPE:
840
ADDRESS:1055 HUNTE PARKWAYTELEPHONE:
(619) 870-6418
CITY:CHULA VISTASTATE: CAZIP CODE:
91914
CAPACITY:60CENSUS: 30DATE:
10/21/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Gillian GorelikTIME COMPLETED:
02:30 PM
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On 10/21/20 at 1:15pm Licensing Program Analyst (LPA) Martha Malane arrived at the facility to conduct a case management inspection for the purpose of an increase of capacity. LPA met with the Program Director Gillian Gorelik and Department Head Miriam Martinez. There were 32 children and 4 staff. This School Age Program currently operates at Salt Creek Elementary School in the following rooms: Building 200 (aka Multi-Purpose room) with the capacity of 60 and is requesting a capacity increase of 84 in new rooms: #201 (aka the Y Room), #304, #402 and #603. Hours of operation are Monday - Friday from 7:00am to 4:30pm.

Rooms were inspected and are equipped with appropriate furniture, including tables, chairs, and other materials for children. Boys/Girls restrooms are located outside the 600 Building and the Library. There is a restroom inside the Y Room. Restrooms are safe and clean and are sufficient to accommodate the new requested capacity of 84 children. Staff stated restrooms are cleaned by a school staff custodian every 2 hours. A staff restroom is located outside the Library. Drinking water is available in classrooms via water dispensers, refillable water bottles brought from home and disposable cups if needed.

The isolation area is located outside the school office and the site supervisor provides supervision of the ill child. LPA discussed disinfectants are to be kept inaccessible. Required documents are posted. There is an operational carbon monoxide detector located in the Y Room and a first aid kit with required supplies. The playground is located outside the Multi-Purpose room and has a grass area, basketball and handball courts and a lunch area with tables and a canopy for shade. Drinking water is available outside via water dispensers, refillable water bottles brought from home and disposable cups if needed.

A fire clearance for 84 school age children (ages kindergarten – 12 years) was granted on 9/23/20.

An increase of capacity for 84 school age children (ages kindergarten – 12 years) may be granted upon final review.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020
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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