191221714-3-14-2023-58-CC-DLOE-CPWW4M-20230314165747

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191221714
Report Date: 03/14/2023
Date Signed: 03/14/2023 04:57:59 PM

Document Has Been Signed on 03/14/2023 04:57 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	YMCA OF METRO LA/NORTH VALLEY GERMAIN		FACILITY NUMBER:	191221714
ADMINISTRATOR:	KATHY LING		FACILITY TYPE:	850
ADDRESS:	20730 GERMAIN STREET		TELEPHONE:	(818) 918-0402
CITY:	CHATSWORTH	STATE: CA	ZIP CODE:	91311
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 28	CENSUS: 18	DATE:	03/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:31 PM
MET WITH:	Lisa Gagliana & Claudia Elias		TIME COMPLETED:	05:05 PM

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On 03/14/2023 Licensing Program Analyst (LPA) Deborah Lowe and Maria Rendon conducted an unannounced Annual Required Inspection and met with Interim Director Lisa Gagliana. LPAs toured the facility indoors and outdoors and a census was taken; 18 children under care and supervision of 2 staff members.

YMCA of Metro LA Program Director, Claudia Elias arrived at facility and LPAs continued the visit with Program Director.

Facility is located at Germain Elementary School.

LPAs observed one school age classrooms, Room 20 is used by YMCA. Days and hours of operation are Monday, Wednesday, Thursday, and Friday 2:23 pm to 6:30 pm. Tuesdays 1:23 pm to 6:30 pm.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Tables and chairs meet the needs of the children in care. LPA Lowe and Rendon observed a carbon monoxide detector located in the classroom behind the teacher’s desk, LPAs were able to hear a successful test of each carbon monoxide detector.

Outdoor area was observed to be located just outside of room 20. Outdoor area was observed to be black top. No hazards observed.

Facility is located on a Los Angeles Unified School District campus, pest control is provided by LAUSD. LPA observed the facility to be free of flies, insects and rodents. No poisons were observed in today’s inspection.

Disinfectants, cleaning solutions and other hazardous items were observed to be inaccessible and stored in locked classroom cabinet. Cabinet was made inaccessible by use of pad locks.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY GERMAIN	FACILITY NUMBER: 191221714
	VISIT DATE: 03/14/2023

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All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe.

Facility does not have access to a kitchen. Facility provides afternoon snacks. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Refrigerator was observed to be clean with thermometer.

Drinking water is available both indoors and outdoors with use of gallon size water bottles from the store. Children have water bottles and the facility has disposable cups available.

Facility has conducted water lead testing to comply with Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test. Facility is pending results to determine if there is an exceedance of 5.5 ppb/ug L and above.

LPAs observed the following postings on the parent board: Facility License, LIC 613A (9/96), the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster, LIC 610 Emergency Disaster Plan with the telephone number of the local health department, information on child passenger restraint systems, and a contingency plan for action during fires, floods and earthquakes.

Menu was not posted in the room. LPAs advised per CC Regulation 101227(a)(6) Food Service (6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.

LPAs reviewed a sample of children’s files and observed files to be complete. YMCA uses an electronic document system. A printed copy of all electronic files was available for view.

Review of staff files show staff files to be complete with mandated reporter, immunization verification of Tdap, MMR, and flu, and health screening.

Review of facility file shows Interim Director has CPR/First Aid completed on 05/08/2022 and has Preventive Health Practices with nutrition and lead components.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY GERMAIN	FACILITY NUMBER: 191221714
	VISIT DATE: 03/14/2023

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The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. LPAs observed sign out sheets with a section for parent/ guardian to sign out using a full legal signature.

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.

Facility representative 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.

LPAs and facility representative discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and appeal rights and this report was reviewed with YMCA of Metro LA Program Director, Claudia Elias.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC809 (FAS) - (06/04)

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