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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495186
Report Date: 10/25/2022
Date Signed: 10/25/2022 06:06:13 PM

Document Has Been Signed on 10/25/2022 06:06 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CII/YMCA EARLY HEAD STARTFACILITY NUMBER:
197495186
ADMINISTRATOR:JUSTINE LAWRENCEFACILITY TYPE:
830
ADDRESS:9900 S VERMONT AVENUETELEPHONE:
(323) 905-1042
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY: 9TOTAL ENROLLED CHILDREN: 9CENSUS: DATE:
10/25/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Justine Lawrence - Representative and Erika Avila - site directorTIME COMPLETED:
02:23 PM
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On 10/25/2022 Licensing Program Analyst (LPA) Jillinda Chandler made an announced visit to CII/YMCA Early Head Start for the purpose of conducting a pre-licensing inspection. LPA met with facility representative- Justine Lawrence and site director- Erika Avila and a tour of the center was provided. The applicant is requesting an Infant component with a capacity of 6 infants ages 0 - 18 months. The day care is located on the YMCA campus, there is a separate entry from the public, located on 99th street side of the building, equipped with electronic entry and cameras. The applicant has a pending preschool application ( 197495187) on file. Infant care will be conducted in room 5, napping will also take place in the same room.
There is an approved fire inspection on file conducted by Inspector Henry Medina of the L.A City Fire Department.

The following was observed of the:

INDOOR ACTIVITY SPACE

Fire extinguishers were 2AB10C or larger was observed

LPA observed carbon monoxide detectors in each classroom and other various areas.

First aid kits were observed with the required essentials: scissors, bandages, tweezers, and thermometer

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CII/YMCA EARLY HEAD START
FACILITY NUMBER: 197495186
VISIT DATE: 10/25/2022
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Central heating and cooling was used to control class room temperature.

Adequate lighting was observed

The classrooms were clean, rugs were in good condition

LPA observed storage bins for children’s belongings.

Trash cans used for solid waste were observed with tight fitting lids

Disinfectants and cleaning solution and other toxins or poisons were made inaccessible to children, placed a storage rooms and locked cabinets.

The directors office will be used for isolation of ill children and the staff restroom located in the hall way on the right hand side will be used for ill children. Director was advised that there needs to be a crib or pack and play for infant that are required to be in a crib.

Applicant is hereby advised to ensure form # LIC 9227- Infant Sleeping Plan to the infants file folder be added to the infants file. All service plans shall be adjusted according to child's needs.

The classrooms are equipped with working telephones and staff will have access to a classroom cell phone for communication. Classrooms have camera access to the front entry.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
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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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CII/YMCA EARLY HEAD START
FACILITY NUMBER: 197495186
VISIT DATE: 10/25/2022
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Parents and authorized adults will sign in using their original signatures and also by using an electronic sign in device - "Child Plus. Applicant is advised that sign in sheets shall be made readily available for review by the department, for a a minimum of 30 days.

The required postings were also posted in a prominent area for parents and visitor's view.

LPA observed age appropriate toys and furniture. The combination of toys shall provide and encourage: Auditory stimulation, Visual stimulation, Tactile stimulation, and Manipulative skills

The napping area was located in with-in the classroom (#5) 6 standard cribs, with no drop down sides were observed for napping. Two of the cribs were equipped with wheels for emergency evacuation. Separation is provided by a partition 4 feet or higher.

LPA observed age appropriate, low feeding chairs and tables. Applicant is advised infants that are unable to sit in chairs, shall be held and fed by staff members.

There was one changing table within arms reach of a sink located in the napping area. Individual cubbies for infants diapering needs were observed over the changing table

No baby walkers or bouncers were observed during today inspection.

The measurements for the indoor activity space was 414.95 divided by 35 SQ. FT. per child = 11 children

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CII/YMCA EARLY HEAD START
FACILITY NUMBER: 197495186
VISIT DATE: 10/25/2022
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FOOD SERVICE:

An outside vendor provides lunches and snacks for older infants, parents are to prepare bottles, the center will heat them according to service plan, It is recommended that bottle fed infants are fed at least every four hours. The center is hereby advised that a supply formula shall to be available for emergency purposes, emergency formula can be provided by parents or childcare center.

The center has a separate food prepping area with refrigeration and heating device for infant foods and formulas. The prepping area was clean in good condition, LPA did not observe any contaminated foods or hazardous conditions in this area, this area is inaccessible to children in care. Infant bottles and foods shall be properly labeled with child’s names and date of preparation. Bottle warmers were observed for heating formula.

Applicant was informed that an individual feeding plan shall discussed and made with the authorized representative and/or physician, prior to the infants first day of care. This plan shall be updated as needed or at the authorized representative's request.

Weekly menus were posted for review. Applicant shall make preparation for alternate meals for children with allergies. The plan shall be in accordance with an Incidental Medical Service plan, and discussed with parents of children with, allergies (epi-pen); asthmatic (inhalers); and children needing Gastronomy tubes (feeding G-tube). Additional information was provided with this licensing report.

Applicant is hereby informed that regulations referencing infant care can be located in Title 22 Division 12 Chapter 1 Sub-chapter 02.- Infant Care Center

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
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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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CII/YMCA EARLY HEAD START
FACILITY NUMBER: 197495186
VISIT DATE: 10/25/2022
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RESTROOMS

THERE WERE:

0 toilets = 1 toilet per 15 children; applicant provided a receipt for 2 potty chairs to be added to the classroom. There shall be 1 potty chair per every 5 infants being potty trained.

1 sinks = 1 sink per 15 children for a total of 15 children

The restrooms were clean and sanitized with the necessary toiletries, sinks and toilets were operable and in good repair. Faucets delivered cold water only.

The sink was standard size, LPA observed a broad based step stool to assist children to access the fixture.

OUTDOOR ACTIVITY SPACE

Age appropriate toys and equipment were observed in the outdoor activity space in good repair.

The play yard was fully gated with a gate approximately 4 feet high.The play yard was separate from other components or programs located on the premises.

Resilient cushioning was observed under all climbing equipment. Cushioning was in good repair.



Shade canopies were available for shade, and portable equipment shall be added for sitting.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CII/YMCA EARLY HEAD START
FACILITY NUMBER: 197495186
VISIT DATE: 10/25/2022
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No hazardous conditions or equipment was observed during today’s visit.

During the visit alerting alarms were added to exit gate leading to the outside of the center.

Ratios and supervision were also discussed during todays inspection according to Title 22 sections 101416.5 and 101416.8

Measurements for the outdoor activity space = 478.512 divided by 75 SQ. FT per child for a total of 11 children

Based on measurements and observations the center shall be recommended for licensing for a total of 6 infants, determined by the outdoor activity space and a subsequent application submitted by the applicant, requesting a capacity of 6 infants.

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.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CII/YMCA EARLY HEAD START
FACILITY NUMBER: 197495186
VISIT DATE: 10/25/2022
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LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Exit interview conducted and report was reviewed with the facility director Erika Avila

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022
LIC809 (FAS) - (06/04)
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