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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700166
Report Date: 08/15/2019
Date Signed: 08/19/2019 10:25:55 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:EAST COUNTY FAMILY YMCA - DAILARDFACILITY NUMBER:
376700166
ADMINISTRATOR:MICHAEL RHONEFACILITY TYPE:
840
ADDRESS:6425 CIBOLA ROADTELEPHONE:
(619) 789-9970
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:160CENSUS: 0DATE:
08/15/2019
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Lucelyna Godwin, Association Program Specialist of Child & YouthTIME COMPLETED:
11:10 AM
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Licensing Program Analysts (LPA's) Michelle Hood and Elizabeth Rivera arrived at the facility for the purpose of conducting a Case Management inspection regarding the facility's request for room changes. Also present was staff Tina Barker - Child Care Accounting and Nick Underwood - Maintenance Supervisor and 0 children in care. The facility operates M-F 6:30am-8:30am and M-F 2:10pm - 6:30pm. The facility operates before and after school, when the elementary school is closed, so they do not commingle with children not participating in the program.

The facility is currently licensed for rooms 26, 27, Multi-purpose room, YMCA/Resource room and Library. The facility has requested to remove room 26 from license and add Lounge, Music and Conference room 3. Rooms 27, Multi-purpose room, YMCA/Resource room and Library will remain on license.

No deficiencies are cited, LIC 9213- Notice of Site Visit (NOS) must be posted for 30 days. LPA observed NOS posted.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
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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