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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400820
Report Date: 12/19/2024
Date Signed: 12/19/2024 05:25:21 PM

Document Has Been Signed on 12/19/2024 05:25 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 OF GLB KETTERING ELEMENTARY SCHOOLFACILITY NUMBER:
198400820
ADMINISTRATOR/
DIRECTOR:		MELISSA CAREYFACILITY TYPE:
840
ADDRESS:550 SILVERA AVETELEPHONE:
(562) 279-1623
CITY:LONG BEACHSTATE: CAZIP CODE:
90803
CAPACITY: 70TOTAL ENROLLED CHILDREN: 22CENSUS: 6DATE:
12/19/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Eric Akalski and Maria OlmedoTIME VISIT/
INSPECTION COMPLETED:
05:50 PM
NARRATIVE
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On December 11, 2024, at 1:45 PM, Licensing Program Analysts (LPA), Elka Chavez conducted an unannounced Case Management inspection for an increase in capacity. Upon arrival, LPA met with Site Supervisor, Christian Cardenas. At approximately 2:30pm, LPA was joined by Eric Akalski, Program Director. The licensee, YMCA of Greater Long Beach is requesting to be licensed for 95 school age children ages 4.9 to 13 in rooms 23, 24 and school's cafeteria. Hours of operation will be Monday through Friday before school 6:30 AM to 8:30 AM and after school from 2:00 PM to 6:00 PM. On Thursdays the facility operates after school from 1:00 PM to 6:00 PM due to the elementary school's early dismissal.

Present during today’s inspection were 22 children with 6 staff. Appropriate ratios and supervision were observed. LPA did not observe Cristian Cardenas, Alondra Serrano, John Cevallos, Karyn Martinez, Reiko Garfias and Cesar McNay associated to this facility. LPA conducted file reviews and review revealed that staff Cristian Cardenas, Alondra Serrano, John Cevallos, Reiko Garfias and Cesar McNay and Karyn Martinez are associated to facility number 198017013 and Cesar McNay is associated to facility number 198000569. LPA confirmed that staff are not employed by the Long Beach Unified School District. Per director, Maria Olmedo the administrative file is 198017013.

This facility is located on the premises of Kettering Elementary School. LPA continued to tour the facility and inspected the existing classrooms and new proposed classroom 24. At 2:20 pm, LPA observed the new proposed classroom B24 did not observe any tables and chairs, and other activity supplies for the children. LPA observed the music teacher inside the classroom. LPA will need to return to the facility due to the proposed classroom not being set up for the facility to use.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 OF GLB KETTERING ELEMENTARY SCHOOL
FACILITY NUMBER: 198400820
VISIT DATE: 12/19/2024
NARRATIVE
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Exit interview conducted and report was reviewed with the Licensee Representative, Maria Olmedo who joined us at approximately 4:15pm.

A notice of site visit was given to Licensee Representative, Maria Olmedo and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
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Document Has Been Signed on 12/19/2024 05:25 PM - It Cannot Be Edited


Created By: Elka Chavez On 12/19/2024 at 03:53 PM
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 OF GLB KETTERING ELEMENTARY SCHOOL
FACILITY NUMBER: 198400820

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
12/20/2024
Section Cited
CCR
101170(e)(2)

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101170(e)(2)(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
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Director stated that they will provide the department with documents they have regarding the administrative file for staff associations
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Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
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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:Monica Cuddy
LICENSING EVALUATOR NAME:Elka Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


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