198015673-9-27-2022-54-CC-MAYA-CJNUMR-20220927154247

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015673
Report Date: 09/27/2022
Date Signed: 09/27/2022 03:43:01 PM

Document Has Been Signed on 09/27/2022 03:43 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 INTENSIVE LEARNING CENTER SITE		FACILITY NUMBER:	198015673
ADMINISTRATOR:	ADRIANA MENDOZA		FACILITY TYPE:	840
ADDRESS:	4718 MICHELSON STREET		TELEPHONE:	(562) 233-7748
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90712
CAPACITY: 100	TOTAL ENROLLED CHILDREN: 45	CENSUS: 40	DATE:	09/27/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Senior Program Director, Michele Janssen		TIME COMPLETED:	04:00 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 September 27, 2022 at 1:30 pm, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced inspection at the facility noted above and met with Senior Program Director, Michele Janssen. The purpose of the inspection was to conduct the Required 1 Year inspection at the facility. Entrance Checklist – Child Care Centers (LIC 125) was provided to the Senior Program Director upon arrival. The facility is currently licensed for 100 school-age children. The after-school program is located at Intensive Learning Center. Per Senior Program Director, the program operates Monday through Friday from 2:30 pm to 6:00 pm with early dismissal on Wednesday's at 1:06 pm. All areas on the facility sketch were inspected. The program provides child care inside Classrooms 80, 81, 85, and utilize the gated outdoor play yard on the campus. Per Senior Program Director, Classroom 85 is currently not in use. Upon arrival, Staff (S1, S2, and S3) were present with 40 children. LPA was informed that parents sign their children out during pick-up while staff sign the children in as soon as they arrive to the program. 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), Daily Activity Schedule, and Earthquake Preparedness (LIC 9148). 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. There was no napping equipment to be inspected. Per Senior Program Director, the isolation area is in the staff lounge which has a restroom that may be used if an ill child requires it. Availability of indoor drinking water was observed inside the classroom.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022

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

FACILITY NAME: YMCA GLB INTENSIVE LEARNING CENTER SITE	FACILITY NUMBER: 198015673
	VISIT DATE: 09/27/2022

NARRATIVE

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Disinfectants, cleaning solutions, and other items that are hazardous to children, were made inaccessible to children in all areas. Senior Program Director confirmed that there are no poisons stored at the facility. The facility provides the children with snacks daily. Snacks are prepared by the Bellflower Unified School District. Per Senior Program Director, no meals are prepared or served at the facility. All storage containers for solid waste have tight-fitting covers that are kept on and in good repair.

The facility has smoke detectors and carbon monoxide detectors that were tested and are operable. The fire extinguisher is fully charged and was last serviced on August 10, 2022. The facility has verification of disaster and fire drills. The last drill was conducted on September 9, 2022. First Aid supplies were observed and kept in the classrooms. According to the Senior Program Director, medication is only administered to a child when accompanied with a doctor's note. At this time, there are no children enrolled requiring medication. This facility does not provide transportation.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 record reviews of five (5) children’s records and four (4) personnel records for completeness. Based on the record reviews, children and staff records were complete with all the required documents per Title 22 regulations. The names of children and staff whose records were reviewed were documented. There is at least one person trained in CPR and Pediatric First Aid present during this visit. All individuals present have obtained a criminal record clearance or criminal record exemption.

Senior Program Director 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: 09/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022

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 INTENSIVE LEARNING CENTER SITE	FACILITY NUMBER: 198015673
	VISIT DATE: 09/27/2022

NARRATIVE

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LPA advised the Senior Program Director 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.

No deficiencies were cited during today’s inspection.

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 Senior Program Director, Michele Janssen. Appeal Rights were discussed, and a copy was provided to the facility representative.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022

LIC809 (FAS) - (06/04)

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