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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700056
Report Date: 10/21/2020
Date Signed: 10/21/2020 01:02:31 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-HEDENKAMP ELEMENTARY SCHOOLFACILITY NUMBER:
376700056
ADMINISTRATOR:ALEXANDRA SALAZARFACILITY TYPE:
840
ADDRESS:930 EAST PALOMAR STREETTELEPHONE:
(619) 397-5828
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY:60CENSUS: 34DATE:
10/21/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Gillian GorelikTIME COMPLETED:
01:15 PM
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On 10/21/20 at 12:00pm, 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 Program Director Gillian Gorelik and Department Head Miriam Martinez. There were 34 children in care with 3 staff. This School Age Program currently operates at Hedenkamp Elementary School in the following rooms: Building 200 (aka Y Room and the Multi-Purpose room) with the capacity of 60 and is requesting a capacity increase to 112 in new rooms: #307, #505, #705 and the Library. 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 available and located in the 300 Building by the grass play area and also in the Y Room. The restrooms are safe and clean and are sufficient to accommodate the new requested capacity of 112 children. Program Director stated bathrooms are cleaned every 3 hours by a school staff custodian. A staff restroom is located outside the Library. Drinking water is available in all of the classroom via water dispensers and children bring refillable water bottles from home and disposable cups are available if needed.

The isolation area for ill children is located in the Multi-Purpose room. 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. A grass play area, black top, basketball courts and lunch area with tables and a canopy for shade is located outside the Multi-purpose room. Water is available outside via water dispensers and disposable cups and refillable water bottles.

A fire clearance for 112 school age children (ages kindergarten – 12 years) was granted on 10/8/20.

An increase of capacity for 112 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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