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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419540
Report Date: 09/12/2025
Date Signed: 09/12/2025 03:16:56 PM

Document Has Been Signed on 09/12/2025 03:16 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:YMCA OF METRO LA/NORTH VALLEY DARBYFACILITY NUMBER:
197419540
ADMINISTRATOR/
DIRECTOR:		MEGAN TISLERFACILITY TYPE:
850
ADDRESS:10818 DARBY AVENUETELEPHONE:
(818) 368-3231
CITY:NORTRIDGESTATE: CAZIP CODE:
91326
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 19DATE:
09/12/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Amanda Rockford; DirectorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On Friday, September 12, 2025, Licensing Program Analyst (LPA) Hanna Cha met with Director Amanda Rockford. The purpose of the visit was to conduct an unannounced Annual/Random inspection of the facility. LPA disclosed the purpose of the inspection to the Director Amanda Rockford. LPA and Director toured the facility. LPA observed two staff providing care and supervision to 19 children. The current days and hours of operation are Monday through Friday from 6:30 a.m. to 8:00 a.m. and after school care from 1:30 p.m. to 6:30 p.m (Tuesday) and 2:30 p.m through 6:30 p.m. (all other weekdays).

Physical Plant/Indoor/Children’s Area:
The facility operates in two classrooms referred to as the YMCA of Metro LA/North Valley Darby Before and After School Age Program. The YMCA program is located in one bungalow separated into two classrooms on Darby Elementary School campus.
The facility was inspected for safety, comfort, cleanliness, good repair, telephone service, heating, lighting, and ventilation. LPA Cha observed labeled cubbies for children's belongings. An isolation area was inspected. Per Director, children do not nap at facility, but are provided mats and blankets if rest time is needed. LPA Cha tested carbon monoxide detector and smoke detector to be in operable condition. Trash bins were observed to have tight fitting lids. Per Director, there are no poisons on the premises. LPA Cha observed the furniture/equipment in good condition. LPA Cha observed no fireplaces and wall heaters.

Bathroom: LPA observed bathroom for safe and sanitary operating condition with no hazardous materials. The facility consists of two children’s restroom (one in each classroom). LPA observed one sink and one toilet in the each children’s restroom. Toilet paper, paper towels, and soap were available to children.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY DARBY
FACILITY NUMBER: 197419540
VISIT DATE: 09/12/2025
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Food Preparation Area: LPA observed the food preparation area (located in classroom A) for safety, sanitation, and good repair. Food preparation area consists of refrigerator/freezer, sink, microwave, toaster oven, and pantry cabinets. Per Director, there are no knives on premises. The only sharp items are apple cutters which are placed in cabinet made inaccessible with child safety locks. Per Director, facility only provides morning and afternoon snack. Menus were observed. Children are provided with filtered water in a Brita dispenser and disposable cups.

Outdoor/Children’s Play Area: LPA inspected the outdoor play space for safety, cleanliness, good repair, age-appropriate toys/equipment, cushioned floors, and shady areas. Per Director, children utilize outside concrete area partitioned with cones. Children are provided play equipment such as balls and hoops.


Pools/Spa/Bodies of Water: Per LPA observation, there are no pools, spas, or bodies of water on the premises.

File Review: LPA reviewed two children files which contained all required information. LPA reviewed two staff files which included all required information. Director CPR/FA expires on 06/2027. Director Mandated Reporter training expires on 03/2026.


Postings: LPA observed required postings as follows: Facility License, Personal Rights (LIC613A), Parent’s Rights Poster, Passenger Car Seat Law (PUB 269), and Emergency Disaster Plan.
Other: Per Director, smoking is prohibited on the premises. Per Director, there are no firearms/weapons stored on premises. Per recorded documentation, Fire/Earthquake drills last completed on 08/2025.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY DARBY
FACILITY NUMBER: 197419540
VISIT DATE: 09/12/2025
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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. The facility provided lead testing results under 5.5 ppb, which are the allowable exceedance tested on 12/13/2022.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During this investigation, LPA Cha did not observe any Title 22 deficiencies. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was printed and reviewed with the Director Amanda Rockford along with Appeal Rights.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2025
LIC809 (FAS) - (06/04)
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