191607806-8-27-2021-54-CC-SSAZ-C6AR4G-20210827124131

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191607806
Report Date: 08/27/2021
Date Signed: 08/27/2021 12:41:38 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	YMCA GLB LOS ALTOS BRANCH - NAPLES ELEMENTARY		FACILITY NUMBER:	191607806
ADMINISTRATOR:	KENNETH SOL		FACILITY TYPE:	840
ADDRESS:	5537 THE TOLEDO		TELEPHONE:	(562) 230-7651
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90803
CAPACITY:	50	CENSUS: 0	DATE:	08/27/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Jesse Pazdernik, Executive Director and Sammy Brittain, Program Director		TIME COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Susann Sanchez arrived at the above facility for the purpose of an case management- Licensee Initiated for the purpose of the facility coming out of inactive status. LPA met with Jesse Pazdernik, Executive Director and Sammy Brittain, Program Director. LPA toured and inspected the facility at 10:10am to ensure the health & safety standards as required by regulations governing Child Care Centers. Hours of operation will 6:30am to 9:30am and again at 12:30pm to 6:30pm Monday, Tuesdays, Wednesday and Fridays. On Thursdays hours will be 6:30am to 9:30am and again 11:30am to 6:30pm. Facility on Naples Elementary campus. The school age program belongs to the YMCA. The YMCA will use the Room 25107 in the future once the fire clearance is approved. Facility will still use the cafeteria and auditorium. The program operates in conjunction with school district calendar. The facility was inspected for ventilation, working telephone (staff use cell phones), inaccessibility to any item which could cause injury or harm children in care. Facility was inspected to ensure the facility sketch is accurate. LPA did not observe any children in care. Facility stated, they were inactive due to COVID19 and construction. The designated isolation area will be the Directors Office in the southeast corner of the cafeteria. Parents will be called immediately if children become sick. Ill children will use the staff restroom located near school office. There is a napping mat available to use in case a child becomes ill while in care. Medications shall be stored in a secured inaccessible cabinet. Medications requiring refrigeration will be stored and secured in the refrigerator in storage area for staff. There is a fully equipped first aid kit available on site. Director Sammy Brittain CPR and First Aid is current and will expire on 12/06/2021.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: YMCA GLB LOS ALTOS BRANCH - NAPLES ELEMENTARY	FACILITY NUMBER: 191607806
	VISIT DATE: 08/27/2021

NARRATIVE

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The furniture and equipment were inspected for age appropriateness and good repair. The facilities telephone service, heating, lighting and ventilation were also evaluated. Children do not nap at the facility. Individual storage for children's belongings and an isolation area with sink, toilet, and mat/cot were inspected.
Parents are dropping off children outside. Children are will be screened daily before entering the the facility. Facility has extra masks, gloves, sanitizer and cleaning supplies. Children and staff will wear face coverings during the day. Per Licensee children will wash hands as they enter the facility. . Toys and materials are sanitized daily. Toy are separated by baskets. Licensee states that bathrooms are sanitized every two hours. Children have hooks to store for their personal belongings. Facility has posting up for parents, staff and children. .

LPA reminded that it is the facility responsibility to know the regulations as well as anyone who assists in providing care. LPA advised on how to access quarterly reports, forms, and regulations for Child Care online at www.cdss.ca.gov. to stay informed of any changes or updates to the regulations.

LPA shared the Child Care Advocate Program (CCAP) participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. Facility may also register on CCAP website for the new quarterly report to be notified. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541. Email address:childcareadvocatesprogram@dss.ca.gov

Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. Director Mandated Reporter Certificate Sammy Brittian expires on 11/20/22

Appointments can be made for Live Scan at 1-800-315-4507.

Licensee is reminded that smoking is prohibited on the premises during hours of operation. Per Licensee there are no bodies of water or firearms in the facility.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: YMCA GLB LOS ALTOS BRANCH - NAPLES ELEMENTARY	FACILITY NUMBER: 191607806
	VISIT DATE: 08/27/2021

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Facility is ready to operate and will be place in active status as of 08/27/2021.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Jesse Pazdernik, Executive Director, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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