<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005598
Report Date: 05/28/2024
Date Signed: 05/28/2024 11:03:04 AM


Document Has Been Signed on 05/28/2024 11:03 AM - 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:MAGDALENA ECKE YMCAFACILITY NUMBER:
372005598
ADMINISTRATOR:KARISA RIDDLEFACILITY TYPE:
850
ADDRESS:200 SAXONY ROADTELEPHONE:
(760) 942-9622
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY:152CENSUS: 96DATE:
05/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Karisa RiddleTIME COMPLETED:
11:15 AM
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
On 5/28/24 at 9:30am, LPA Patrick Ma made an unannounced visit to conducted case management inspection for the purpose of following up on an incident that was self reported on 5/22/2024.

On 5/20/24 around 4:30pm, Staff S1 and S2 were supervising 15 children outside as parents began picking up their children. After speaking with a parent, S2 noticed child C1 missing from the playground. S1 and S2 began looking for missing child and found C1 inside their classroom bathroom. Both staff reported seeing child C1 outside on the playground at about 4:30pm and found C1 inside the classroom at 4:32pm. Primary classroom door has child safety gate preventing child from leaving the classroom.

See 809D for deficiency cited.

Exit interview conducted and report was reviewed with the Director Karisa Riddle. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick MaTELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:
DATE: 05/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/28/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 05/28/2024 11:03 AM - It Cannot Be Edited

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: MAGDALENA ECKE YMCA
FACILITY NUMBER: 372005598

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/29/2024
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
101229(a)(1) SUPERVISION - No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation.
This regulation was not met as evidenced by LPA's interview of staff.
1
2
3
4
5
6
7
Director stated pick up procedures has been updated to reduce similar situation. Outdoor classroom doors are locked when children are outdoors and parents are asked to pick up from playground entrance from now on. Deficiency is now cleared.
8
9
10
11
12
13
14
Based on interviews and records review, child C1 was missing for 1-2 mintues when child went inside their classroom to use the bathroom which poses an potential health and safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick MaTELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:
DATE: 05/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/28/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2