304371492-4-27-2021-06-CC-KDEI-C2GS9A-20210427134024

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371492
Report Date: 04/27/2021
Date Signed: 04/27/2021 01:40:38 PM

Document Has Been Signed on 04/27/2021 01:40 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	YMCA OF GREATER WHITTIER-RANCHO PRESCHOOL		FACILITY NUMBER:	304371492
ADMINISTRATOR:	EPTING, SHAUNA		FACILITY TYPE:	850
ADDRESS:	14540 SAN CRISTOBA DRIVE		TELEPHONE:	(951) 334-5622
CITY:	LA MIRADA	STATE: CA	ZIP CODE:	90638
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	04/27/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Administrator Ms. Epting Shauna		TIME COMPLETED:	12:45 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) Ms. Ketki Desai conducted an announced on site pre-licensing inspection at the proposed childcare center. LPA met with Administrator Ms. Epting Shauna who gave a tour of the Child Care Center. The applicant has requested to provide care and supervision for 36 Pre-school age children 2 to 5 years of age, Monday through Friday, 6.30 am. to 6.30 PM. in the assigned one classroom. Facility also has an Infant component on site (304371493) with a capacity of 12 infants. A review of the Facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Parents and children shall have access through the entrance gate on the sidewalk leading directly into the walkway passage area of the classrooms. Parents shall park their cars in the parking lot and walk through the side entrance gate to access the classrooms. However, at this time due to COVID Pandemic parents are not allowed inside, children shall be received at the entrance door by the staff, temperatures shall be checked, hands will be sanitized before they are taken to their classrooms. Parents sign them in at the entrance manually, currently outside visitors are not allowed in the facility. This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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. (Page-1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA OF GREATER WHITTIER-RANCHO PRESCHOOL	FACILITY NUMBER: 304371492
	VISIT DATE: 04/27/2021

NARRATIVE

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Medication will be stored in the classroom in a locked cabinet and shall be administered by the teacher or the Facility in charge, emergency First Aid kits are stored in the classroom in assigned cabinets. Medication administration forms were reviewed. Isolation area is the Meeting office room in the Administrative building, the meeting room is located next to the Director’s office and has a bathroom. Administrative building is across the Preschool and Infant room building. This room does have a storage room where additional cot and linens will be stored for the sick child.

The following were inspected in the indoor activity space:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through water fountains, pitchers as well as individual sports bottles if they prefer
· Sign in/Sign out procedure was reviewed and meets regulation requirements (manual sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements
· Cubbies available for storage of individual child’s personal belongings and/or bedding
· Napping equipment: Cot are used and are stored in the corner of the room. Napping linens are brought from home
· Facility shall provide two snacks and lunch through the day, and it prepared in the facility kitchen.

LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393)
· Personal Rights (LIC 613A)
· Menus / Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies / Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269)
· COVID Posters (Page-2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA OF GREATER WHITTIER-RANCHO PRESCHOOL	FACILITY NUMBER: 304371492
	VISIT DATE: 04/27/2021

NARRATIVE

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Facility has one Preschool room and the measurements are as follows:

Preschool room: 35’67 X 29’25 = 1043’35 – 28’42 (Encumbered) = 1014’93

1014’93 divided by 35= 29 children . Capacity requested: 36 preschool children (Limiting factor is the indoor space)

Total sinks: 2 X 15= 30 (children)
Total Toilets: 2 X 15= 30 (children) Toilets are inside the classrooms

LPA observed 2 sinks in the classroom. Toilets and sinks were observed to age appropriate in all the bathrooms observed. Bathrooms were clean and accessible to children.

The following were inspected in the outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers and personal water bottles.
· Outdoor activity space is supplied with age and size appropriate equipment, and outdoor activity toys
· Adequate shade is provided by shaded roof surrounding the bike trail surrounding it and easy up's tents for additional shades.

Outdoor space measurements:

Preschool yard: 155 X 149 = 23095

Total Outdoor space: 23095 divided by 75 = 307’93 (308 children)

Based on the indoor measurements, sink and toilet availability, facility has enough space to accommodate only 29 children and not the capacity as requested for 36 Preschool age children (age 2- 5 years) in the assigned one classroom
(Page-3)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA OF GREATER WHITTIER-RANCHO PRESCHOOL	FACILITY NUMBER: 304371492
	VISIT DATE: 04/27/2021

NARRATIVE

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Fire clearance received from LA county Fire Department have approved the requested capacity of 48 children in the two assigned rooms. (36 Preschool and 12 Infants)

Facility Administrator is current on the required Immunization/ Pediatric CPR/ First training valid through 1/2022 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component)

Facility has also completed the new Water testing requirement and analytical report is on file.

LPA discussed with the applicant that all employees must have criminal record clearances associated to the facility prior to their presence in the facility, staff to child ratio requirements, direct visual supervision requirements, emergency/disaster drills, children records, mandated reporter training, and staff immunization requirements against measles, pertussis, and influenza. Applicant was advised the children's bedding must be stored individually and may not touch another children's bedding.

The applicant was given a pamphlet on Lead Exposure and was discussed with provider. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org. The Chaptered Legislation for AB 2084 (Nutritious Beverages) is available to view on the website at: http://ccld.ca.gov/res/pdf/12APX-11.pdf

Applicant was informed of Mandated Reporter Training for self and all assistants. Department web site form was given to down load forms, Title 22 regulations, and training's on-line at www.ccld.ca.gov. The applicant was also informed to visit the website for Quarterly Updates. The applicant was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. or at www.ccld.ca.gov

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The applicant/facility representative was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness

(Page-4)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA OF GREATER WHITTIER-RANCHO PRESCHOOL	FACILITY NUMBER: 304371492
	VISIT DATE: 04/27/2021

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A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the applicant/facility representative.
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf
Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

The facility was following Title 22 requirements at the time of the inspection. Based on today’s measurements, and the sink and toilet availability, this center has enough activity space to support the capacity of 29 Preschool children in the assigned 1 classroom. On the campus of Norwalk La Mirada school district.
A license will be issued for the capacity of 29 preschool children age 2-5 years old, after a final review. The applicant will be notified if any additional information is required.

Applicant was also advised, once licensed, the Notice of Site Visit must be posted for 30 days and if A violations are cited then the Licensing Report (LIC809 or 9099) must be posted by the Notice of Site Visit for a period of 30 days or $100 civil penalties will be assessed, and the report shall posted and copies provided to the parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file
Exit interview was conducted and a copy of this report was provided to the director on this date.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The applicant was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days
(End of Report)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

LIC809 (FAS) - (06/04)

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