198016279-9-1-2026-54-CC-JESA-DXHUUW-20260901155412

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016279
Report Date: 09/01/2026
Date Signed: 09/01/2026 03:54:27 PM

Document Has Been Signed on 09/01/2026 03:54 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	YMCA GLB FAIRFIELD FAMILY SITE		FACILITY NUMBER:	198016279
ADMINISTRATOR/ DIRECTOR:	ANGELICA CORTEZ		FACILITY TYPE:	840
ADDRESS:	4949 ATLANTIC AVENUE		TELEPHONE:	(562) 423-0491
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY: 38	TOTAL ENROLLED CHILDREN: 38	CENSUS: 29	DATE:	09/01/2026
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Jesse Ramos-Shyman-Youth Development Director		TIME VISIT/ INSPECTION 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	Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required annual inspection at the facility. LPA met with Youth Development Director Jesse Ramos-Shyman and informed him of the reason for the visit. At the time of arrival LPA observed 4 children in care with 1 staff. LPA was guided on a tour of the licensed areas by Facility Representative. This is a before and after school program that operates Monday through Friday from 6:30 AM to start of school session and 2:00 PM to 6:00 PM/ 1:15 PM to 6:00 PM (on Thursdays) during the school year. LPA inspected areas used by children. Children enter through the main entrance of the YMCA building. The licensed center is past the front desk. Upon entering the licensed rooms, the required documents were observed to be posted for public view. There are three classrooms used by the program. Each classroom had age-appropriate furniture and equipment in good repair for children's use. There are materials and activities available for children. There is ventilation via A/C unit in the building. No hazards were observed in the classrooms. Water is provided via water container and and water bottles and cups and water dispenser. This facility administers medication which is kept in the office and is inaccessible to children in care. There are two restrooms available for children's use. The girls restroom has one available toilet and two sinks. Two toilets are currently being repaired. The boys restroom has two toilets, one urinal and two sinks. The facility provides a snack for supper via an outside vendor. The facility posts a list of allergies in the storage/kitchen area for all staff to review.

Warren Birks
Jeanette Estrada
	DATE: 09/01/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2026

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

FACILITY NAME: YMCA GLB FAIRFIELD FAMILY SITE	FACILITY NUMBER: 198016279
	VISIT DATE: 09/01/2026

NARRATIVE

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In the mornings, parents sign children in and YMCA staff sign children out once they will be transported to school. In the afternoons, children are transported from their schools to the center and they are signed in by YMCA staff and signed out by parents at pick up at the end of the day. YMCA staff conducts health checks of children upon arrival or pick up.
The licensed outdoor area is completely separate from the rest of the facility. It is fully enclosed. LPA observed tables and benches available for children. There is also a climbing structure with appropriate cushioning in the fall zones. LPA did not observe hazards in the outdoor area. Per Facility Representative, water is brought out for children when they are outside.

There is a pool on the premises of the YMCA. It is not used by the licensed center. Per Facility Representative, if a child is scheduled to use the pool during the operating hours of the licensed center, they must be signed out of the center by a parent and escorted by the parent to the pool. The pool is fully enclosed. From the inside of the building it is accessed through a hallway by members and only used during specific times during the day. The door to the pool is kept locked during the times it is not in use. LPA and Facility Representative discussed pool safety practices.

LPA reviewed staff files which were complete. At least one staff member present has a current pediatric first aid/cpr certificate which expires in 06/2027.
Children's files were reviewed. Children's files are kept digitally but are readily available for review. There are smoke and carbon monoxide detectors in the facility. There is a fire extinguisher available in the facility.

Facility Representative 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.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/01/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2026

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

FACILITY NAME: YMCA GLB FAIRFIELD FAMILY SITE	FACILITY NUMBER: 198016279
	VISIT DATE: 09/01/2026

NARRATIVE

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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 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Facility tested for lead in water on 2/19/2023 with no lead exceedance.

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 PIN 22-02-CCP. 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/.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No citations were issued during today's inspection. A notice of site visit was given to Facility Representative and must remain posted for 30 days. Exit interview conducted and report was reviewed with Facility Representative Jesse Ramos-Shyman.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jeanette Estrada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/01/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2026

LIC809 (FAS) - (06/04)

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