197401067-6-11-2026-30-CC-ALUZ-DUXUK7-20260611153841

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197401067
Report Date: 06/11/2026
Date Signed: 06/11/2026 03:39:15 PM

Document Has Been Signed on 06/11/2026 03:39 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	YMCA OF METRO LA/GARDENA-CARSON PRESCHOOL		FACILITY NUMBER:	197401067
ADMINISTRATOR/ DIRECTOR:	ASHLEY AMBROSE		FACILITY TYPE:	850
ADDRESS:	1000 W. ARTESIA BLVD		TELEPHONE:	(310) 879-6673
CITY:	GARDENA	STATE: CA	ZIP CODE:	90248
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 31	CENSUS: 17	DATE:	06/11/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Natalie Farias		TIME VISIT/ INSPECTION COMPLETED:	04:05 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	On 6/11/26, Licensing Program Analysts (LPAs) Angela Luz and Patsy Plancarte met with Interim Director Natalie Farias to conduct a Case Management - Incident visit to follow up on self-reported incident that occurred on 5/22/26 at YMCA of Metro LA/Gardena-Carson Preschool located at 1000 W. Artesia Blvd. The El Segundo Regional Office received incident report on 5/22/26. Upon arrival, LPAs observed 17 preschool children supervised by 5 fingerprint cleared staff. The facility reported an incident that occurred at approximately 9:40AM during bathroom time. Children were being supervised when Child 1 (C1) entered the bathroom and Child 2 (C2) was already inside. C1 stood behind C2 and made repeated thrusting motions. Staff 1 (S1) intervened and told C1 to stop, as such behavior was not appropriate. S1 separated the children. S1 spoke with C1 about practicing body safety, respecting peer's personal space, and explaining that the interaction was not appropriate or safe. S1 increased supervision of C1. Authorized representatives of both children were informed and each received an incident report. Facility has an action plan on file for C1.

NAME OF LICENSING PROGRAM MANAGER: Maureen Neal
NAME OF LICENSING PROGRAM ANALYST: Angela Luz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA/GARDENA-CARSON PRESCHOOL	FACILITY NUMBER: 197401067
	VISIT DATE: 06/11/2026

NARRATIVE

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LPAs inspected the bathroom area. The bathroom is shared bathroom between the Lilies and Lemons classrooms with half doors on each side. LPAs noted a row of 3 toilets across from a row of 3 sinks. Interim Director stated that staff stay outside of the door to supervise unless a child needs assistance, per company policy. During the visit, LPAs observed staff supervising children using the bathroom while standing outside of the bathroom door.

Per company policy, children of the same gender are allowed to use the bathroom at the same time. Since the incident, the facility now allows one child to use the bathroom at a time. Interim Director stated that if two or more children need to use the bathroom at the same time, a staff will step into the bathroom for supervision. Facility may get partitions added into the bathroom to separate the toilets.

Children involved and staff witnesses were not present at the facility today. LPAs reviewed incident reports given to families and obtained copies. LPA Luz reviewed report made on an internal company form. The Unusual Incident Report was made to the Department in a timely manner. LPA Luz noted the incident did not occur due to a lack of supervision by center staff.

At this time, based on information received, no citations are issued today.

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

Exit interview conducted and report was reviewed with the Interim Director Natalie Farias.

NAME OF LICENSING PROGRAM MANAGER: Maureen Neal
NAME OF LICENSING PROGRAM ANALYST: Angela Luz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026

LIC809 (FAS) - (06/04)

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