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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817599
Report Date: 04/21/2023
Date Signed: 04/21/2023 03:22:56 PM

Document Has Been Signed on 04/21/2023 03:22 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:YMCA JUDSON AND BROWN SCHOOL AGE SITEFACILITY NUMBER:
364817599
ADMINISTRATOR:SAUER, KELLYFACILITY TYPE:
840
ADDRESS:1401 PENNSYLVANIA AVE.TELEPHONE:
(909) 735-6844
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY: 75TOTAL ENROLLED CHILDREN: 62CENSUS: 37DATE:
04/21/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jasmine Garnett, Site DirectorTIME COMPLETED:
03:30 PM
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On 04/21/2023, Licensing Program Analysts (LPAs) Kay Turner and Raymond Moorehead, Jr arrived at the facility on a case management visit to follow-up on an unusual incident report submitted by the facility on 02/17/2023. At the time of visit, LPAs toured the facility (specifically were the reported incident took place), took census, and met with Site Director, Jasmine Garnett, to discuss the reported incident. During the visit, LPA also spoke with children who witnessed the incident as it took place. The subject child involved in the incident was not interviewed by the LPAs as the child no longer attends.

Based on the information obtained during the visit, as well as an inspection of the equipment (photographs of file), there appeared to be no violations of Title 22 Regulations pertaining to the reported incident.

An exit interview was held with Site Director, Jasmine Garnett. A Notice of Site visit was issued, along with a copy of this report. This report shall be public record for three years.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2023
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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