198000062-12-19-2022-54-CC-MAYA-CM5RFZ-20221215115957

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198000062
Report Date: 12/15/2022
Date Signed: 12/19/2022 01:12:35 PM

Document Has Been Signed on 12/19/2022 01:12 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	YMCA GLB WEINGART-LAKEWOOD YMCA SITE		FACILITY NUMBER:	198000062
ADMINISTRATOR:	CHANELLE COLLO		FACILITY TYPE:	840
ADDRESS:	5835 E. CARSON ST.		TELEPHONE:	(562) 425-7431
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90713
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	12/15/2022
TYPE OF VISIT:	Annual/Random	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Program Managaer, Jessica Quintero		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	On December 15, 2022 at 9:00 am, Licensing Program Analyst (LPA) Monique Ayala conducted an announced inspection at the facility noted above and met with Program Manager, Jessica Quintero. The announced inspection was due to the facility currently being on inactive status and requesting to operate again. The purpose of the inspection was also to conduct the Annual/Random inspection. Entrance Checklist – Child Care Centers (LIC 125) was provided to the Program Manager upon arrival. The school-age program is located at the Lakewood Family YMCA. Per Program Manager, the program operates Monday through Friday from 6:30 am to 6:00 pm while children within the Long Beach Unified School District are on school breaks. The program provides child care inside the gymnasium. Based on interview with the Program Manager and LPAs observations, the facility does not have outside activity space available for the children however, the children are able to participate in physical exercise activities inside the gym. Upon arrival, no children or other staff were present. LPA was informed that parents/guardians sign their children in and out when they enter the facility from the back entrance prior to the children entering the gym. The following documents are posted in a prominent, publicly accessible area at the facility: Facility License, Menu, Child Passenger Restraint System Poster (PUB 269), Notification of Parents' Rights (PUB 393), Emergency Disaster Plan (LIC 610), Personal Rights (LIC 613A), and Daily Activity Schedule. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Sinks and toilets were inspected for availability and good repair. General sanitation was observed. Per Program Manager, the isolation area is located in the Teen Center, and the staff restroom is available if an ill child requires it. The Teen Center and staff restrooms is located adjacent to the gym. Availability of indoor drinking water was observed (water jugs and drinking fountains).

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022

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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Document Has Been Signed on 12/19/2022 01:12 PM - It Cannot Be Edited

Created By: Monique Ayala On 12/15/2022 at 10:55 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: YMCA GLB WEINGART-LAKEWOOD YMCA SITE	FACILITY NUMBER: 198000062
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101212(c)

Reporting Requirements

(c) The licensee shall notify the Department in writing of his/her intent prior to making any structural changes that reduce the total amount of indoor or outdoor activity space. Such structural changes shall include, but not be limited to, room additions. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above as the facility no longer has outdoor activity space available and is only utilizing the gym for children which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/16/2023
	Plan of Correction
1 2 3 4	Program Manager will submit to the Monterey Park Child Care Regional Office an updated Facility Sketch (LIC 999) and waiver request in reference to California Code of Regulations, Title 22, Division 12, 101538.2(a) Outdoor Activity Space for School-Age Children for further review.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Valarie Cook

LICENSING EVALUATOR NAME:

Monique Ayala

LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: YMCA GLB WEINGART-LAKEWOOD YMCA SITE	FACILITY NUMBER: 198000062
	VISIT DATE: 12/15/2022

NARRATIVE

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Disinfectants, cleaning solutions, and other items that are hazardous to children, were made inaccessible to children in all areas. Program Manager confirmed that there are no poisons stored at the facility. The facility provides the children with snacks. Per Program Manager, children bring their own lunch from home. The kitchen/food preparation area was inspected for safety and cleanliness. All storage containers for solid waste have tight-fitting covers that are kept on and in good repair.

Carbon monoxide detector was tested and is operable. Smoke detectors were not tested during today's inspection due to being wired to the emergency pull down system. The fire extinguisher located in the gym is fully charged and was last serviced on July 1, 2022. First Aid supplies were observed and kept in the Teen Center. According to the Program Manager, medication is only administered to a child when accompanied with a doctor's note. This facility does not provide transportation. A pool is located on the premises and is only used by the YMCA (Fitness Members) and the Accredited Day Camp Program (American Camping Association). LPA observed the pool to be properly fenced and made inaccessible to children in care per licensing regulations.

This facility provides Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA conducted a record review of one (1) personnel record for completeness. Based on the record review, the Director's record is complete with all the required documents per licensing regulations. Director, Araceli Mota has a current and valid CPR and Pediatric First Aid certification. LPA did not conduct a review of children's records due to the facility not having any children currently enrolled to the program.

Program Manager 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: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: YMCA GLB WEINGART-LAKEWOOD YMCA SITE	FACILITY NUMBER: 198000062
	VISIT DATE: 12/15/2022

NARRATIVE

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LPA advised the Program Manager on how to access forms, regulations, quarterly updates, and Provider Information Notices (PINs) on the Department website at: www.ccld.ca.gov.

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.

During the inspection, LPA obtained a copy of the Camp Schedule which provided the dates that the program will be operating in 2023.

Deficiency was cited during today’s inspection (refer to deficiency page).

A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with Program Manager, Jessica Quientero.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022

LIC809 (FAS) - (06/04)

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