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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700173
Report Date: 12/15/2021
Date Signed: 12/15/2021 04:44:33 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 - VETERANS ELEMENTARY SCHOOLFACILITY NUMBER:
376700173
ADMINISTRATOR:CRYSTAL LOPEZFACILITY TYPE:
840
ADDRESS:1550 MAGDALENA AVENUETELEPHONE:
(619) 216-1226
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY:60CENSUS: 17DATE:
12/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Alysa VillalvaTIME COMPLETED:
05:00 PM
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On 12/15/21 at 2:15 p.m., Licensing Program Analyst (LPA) Casey Gulley conducted an annual inspection. Upon arrival, LPA met with Site Supervisor , Alyssa Villalva and proceeded to tour the facility. There were 17 children in care, along with one additional staff. Facility is within ratio and capacity limitations. Child care operation hours are Monday through Friday from 6 am to 7:15 a.m. and 2:15 p.m. to 6:00 p.m. LPA conducted a tour of the facility/outdoor play area to ensure compliance with standards established in CCR, Title 22, Division 12, Chapter 3.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Allysa Villalva .

SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Casey GulleyTELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
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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