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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806244
Report Date: 07/31/2024
Date Signed: 07/31/2024 05:47:02 PM

Document Has Been Signed on 07/31/2024 05:47 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:SOUTH BAY FAMILY YMCA - TIFFANY ELEMENTARYFACILITY NUMBER:
370806244
ADMINISTRATOR/
DIRECTOR:		GEORGINA PUGAFACILITY TYPE:
840
ADDRESS:1691 ELMHURST STREETTELEPHONE:
(619) 421-6300
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: DATE:
07/31/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Site Supervisor Georgina PugaTIME VISIT/
INSPECTION COMPLETED:
05:50 PM
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On 07/31/24 at 3:00PM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced visit for the purpose of an annual inspection and met with Site Supervisor, Georgina Puga. This is a before and after school program which operates on a traditional school year schedule. Days and hours of operation are Monday - Thursday from 6:00 AM - 8:45 AM and 3:10 PM - 6:00 PM and Fridays from 1:55PM - 6:00PM. There were 30 children present at program's high point today with three staff members caring for the children including, Site Supervisor Gerogina Puga, Teacher Kathlein Ollares and Aide Katia De Leon.

Per Site Supervisor Puga, there is currently one classroom, the T-8 YMCA Child Care Room, in operation which the program was using today but the facility also has rooms #401, #601, #607, #309 (the music room) and the multi-purpose room as approved supervision areas. The program uses a shaded black top area and field located in an area behind the classroom for outdoor activities that are conducted under the supervision of staff. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children are toxic free. All toilets and hand-washing facilities are in safe and sanitary operating condition. All floors in the facility are clean and safe. Facility provides children with one snack daily. All food is protected against contamination.

Solid waste storage containers have tight-fitting covers and are in good repair. Children bring individual water bottles from home and drinking water is also available via a water dispenser as well as campus water fountains. Menus are posted at least one week in advance where an authorized representative can view them. The last Fire/Disaster drill was conducted and documented on 07/26/24.

The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: SOUTH BAY FAMILY YMCA - TIFFANY ELEMENTARY
FACILITY NUMBER: 370806244
VISIT DATE: 07/31/2024
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A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The person who signs the children in/out of the facility shall use their full legal signature and record the time of day.

LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child. LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training.

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. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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-carecenters.

Director 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.

No deficiencies were cited during today's visit.

Exit interview was conducted and report was reviewed with Site Supervisor Puga.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
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