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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700049
Report Date: 09/17/2021
Date Signed: 09/17/2021 08:23:45 AM

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:MARCELO BENHEZFACILITY TYPE:
840
ADDRESS:1055 HUNTE PARKWAYTELEPHONE:
(619) 397-5494
CITY:CHULA VISTASTATE: CAZIP CODE:
91914
CAPACITY:84CENSUS: 7DATE:
09/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
07:15 AM
MET WITH:Alexandra SalazarTIME COMPLETED:
08:30 AM
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On September 17, 2022, at 7:15 a.m.,  Licensing Program Analyst's (LPA's) Gloria Gonzalez and Martha Malane, conducted an unannounced Annual Inspection and met with Director, Alexandra Salazar.  LPA's disclosed the purpose of the inspection and toured the facility indoors and outdoors. The morning program operates from 6:00 a.m. to 8:15 a.m. and the afternoon program operates from 2:15 p.m. to 6:00 p.m.  There is currently one classroom in operation, RM 201.  Director was advised to send in required documents for current changes. The following ratios were observed:
Classroom #201:7 children
There were 7 children present with 3 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 handwashing facilities are in safe and sanitary operating condition.  All floors in the facility are clean and safe.  All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin.  All food is protected against contamination. Contaminated food is discarded immediately.  Solid waste storage containers have tight-fitting covers and are in good repair.  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. 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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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 - SALT CREEK ELEMENTARY
FACILITY NUMBER: 376700049
VISIT DATE: 09/17/2021
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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.  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 requested to be submitted 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's 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's and Director, 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 Director.  Director was provided a copy of their appeal rights (LIC 9058)
LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. 
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
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