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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700147
Report Date: 03/29/2022
Date Signed: 03/29/2022 02:33:42 PM


Document Has Been Signed on 03/29/2022 02:33 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:LA JOLLA YMCA - TORREY PINES ELEMENTARYFACILITY NUMBER:
376700147
ADMINISTRATOR:ZHANG, SHERRYFACILITY TYPE:
840
ADDRESS:8350 CLIFFRIDGE AVENUETELEPHONE:
(858) 453-2323
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY:130CENSUS: 53DATE:
03/29/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Brenda Stevens, Program DirectorTIME COMPLETED:
02:45 PM
NARRATIVE
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On 3/29/22 at approximately 1:20 PM, Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced case management inspection. LPA was met at the entry point by Jenifer Sedero, Associate Executive Director. LPA introduced himself, displayed his department identification and explained the purpose of the visit. The purpose of this visit was to review California Department of Public Health (CDPH) Guidelines regarding COVID-19. LPA was later joined by Brenda Stevens, Program Director.

The classrooms were toured, and LPA observed that the facility was operating within ratio & capacity. Physical distancing, hand-washing stations and sufficient and current resources were observed. COVID-19-related safety and informational posters are visibly posted for parents, children and staff.
Following the tour, LPA discussed with Director Stevens the current COVID-19 guidance including but not limited to masking, vaccines, visitors, isolation for illness, responding and reporting positives and outbreaks and travel considerations. The director is aware that mask use is highly recommended. LPA provided the director with COVID-19 printouts of CDPH guidance and the weblink to the current guidance https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx). LPA also discussed and provided the Director with printouts of Provider Information Notices (PIN) 22-01.1-CCLD, and 22-10-CCP related to current COVID-19 guidance.

When asked, the Director outlined COVID-19 protocols that have been implemented at the center to include but not limited to; staying current with COVID-19 guidance and resources, hand washing and cough etiquette practices and signs, ongoing communication with families and staff, having assigned staff sanitize and disinfect the center, including high traffic surfaces.

No deficiencies were cited during this inspection.

An exit interview was conducted, and a copy of this report was reviewed with Director Stevens. A notice of site visit was given to Director Stevens which must remain posted for 30 days.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Daniel PenaTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2022
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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