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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700166
Report Date: 03/16/2023
Date Signed: 03/16/2023 04:09:57 PM


Document Has Been Signed on 03/16/2023 04:09 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:EAST COUNTY FAMILY YMCA - DAILARDFACILITY NUMBER:
376700166
ADMINISTRATOR:SAMANTHA SMITHFACILITY TYPE:
840
ADDRESS:6425 CIBOLA ROADTELEPHONE:
(619) 860-5900
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:160CENSUS: 105DATE:
03/16/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Samantha SmithTIME COMPLETED:
04:15 PM
NARRATIVE
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On March 16, 2023 at 2:00 p.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced Case Management inspection, for reported Lead Exceedance. LPA met with Director, Samantha Smith and proceeded to tour the facility. Also present in the facility were 105 daycare children and 13 teachers/staff. Facility was within ratio & capacity. LPA observed staff member Albert M. Torres providing care and supervision to daycare children. Mr. Torres does not have a criminal record clearance and he is not associated to the facility. Mr. Torres and Director Smith state that Mr. Torres has worked at the facility since August 2019. Ms. Marissa Armas, Department Head-East County, Child and Youth Development of the YMCA arrived at the facility at approximately 2:35 p.m. LPA interviewed staff and examined the faucets and drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and required forms (LIC 9275/9276) to the Department on 1/8/23.

The following faucets and drinking fountains reported with 5.5 ppb or greater lead exceedance levels were as follows:

Multi-use/food prep/drinking faucet C 5.6 ppb

Director reported that the faucet in exceedance was replaced and retested on 1/31/23. The facility was notified that the faucet was in compliance on 2/9/23. Prior to replacement, the water to the faucet was disconnected. In addition, caution tape and a “do not use sign” was placed on the faucet. All staff were informed not to use the faucet for drinking water or food preparation. Children bring water bottles to school each day and the facility refills their water bottles with store bought bottled water. Bottled water is also used for food preparation. The director states that parents were notified of the lead exceedance by Dailard Elementary via email. LPA observed a parent notification of lead exceedance document on the facility bulletin board.

See LIC809D for deficiency cited. A civil penalty has been assessed.

SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2023
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 4


Document Has Been Signed on 03/16/2023 04:09 PM - It Cannot Be Edited

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: EAST COUNTY FAMILY YMCA - DAILARD
FACILITY NUMBER: 376700166

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/16/2023
Section Cited

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Written Directives: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:
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The director states that the water faucet in exceedance was made inaccessible to children. The water was disconnected, and a “do not use sign” and caution tape were placed on the faucet. The faucet was replaced and retested on 1/31/23 and no longer has an action level exceedance.
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Based on water testing results and interviews, facility tested over the Action Level Exceedance level at one water faucet, multi-use/food prep/drinking faucet-C. This poses a potential health, safety or personal rights risk to children in care.
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While the faucet was inoperable children filled their water bottles with bottled water and food was prepared with bottled water. The deficiency has been cleared.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 03/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4


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: EAST COUNTY FAMILY YMCA - DAILARD
FACILITY NUMBER: 376700166
VISIT DATE: 03/16/2023
NARRATIVE
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LPA Curtis informed Director Smith and Marissa Armas that this report dated 3/16/23 documents one Type A Citation. Type A citations shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Curtis informed Director Smith and Ms. Armas to provide a copy of this licensing report dated 3/16/23 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Director Samantha Smith and Ms. Armas. A copy of PIN 21-21-CCP was provided. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/16/2023 04:09 PM - It Cannot Be Edited

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: EAST COUNTY FAMILY YMCA - DAILARD
FACILITY NUMBER: 376700166

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/17/2023
Section Cited

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101170(e)(1) Criminal Record Clearance: (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:(1) Obtain a California clearance or a criminal record exemption as required by the Department...This requirement was not met as evidenced by:
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The director had Mr. Torres leave the facility at the time of inspection. The director states that she will have Mr. Torres have his fingerprints taken for a criminal record clearance by 3/17/23. The director will send LPA a copy of the LiveScan receipt.
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Based on observation and record review Albert Torres was providing care and supervision to children on 3/16/23 without a criminal record clearance or association to the facility. This poses an immediate health and safety risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 03/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4