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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105068
Report Date: 10/15/2024
Date Signed: 10/15/2024 04:01:06 PM

Document Has Been Signed on 10/15/2024 04:01 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:YMCA TEENS IN MOTION: RANCHO BERNARDO HIGHFACILITY NUMBER:
376105068
ADMINISTRATOR/
DIRECTOR:		SELENA ROMANFACILITY TYPE:
840
ADDRESS:13010 PASEO LUCIDOTELEPHONE:
(619) 873-7134
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 13DATE:
10/15/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Selena Roman TIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On 10/16/24 at 1:45 pm, Licensing Program Analyst (LPA), Gerald Poindexter, conducted an unannounced annual inspection. LPA met with Selena Roman, site director. A tour of the facility was conducted. The program operates in bungalow E14 located at Rancho Bernardo High School. A fire clearance was granted on 07/26/2021. Per Health and Safety Code Sections 1596.806(a), (a)(1), (1)(2) and (d) this program is exempt from square footage, fencing, outdoor activity space, toilet and isolation requirements. Outdoor play area includes grassy quad located near the center of the school.

Ms. Roman stated that the staff will also go on walks around the school for additional outdoor activities. The room is equipped with tables and chairs and age-appropriate equipment and activities. Drinking water is readily accessible via water cups and refillable water jugs. Medications are kept in locked drawer and inaccessible to children. Classroom also has a complete first aid kit, operational refrigerator, and operational carbon monoxide detector. Facility provides PM snacks prepared in the classroom. Snacks are in a refrigerator and storage closet, both secured by safety latch. Classroom has a storage cabinet for cleaning supplies which are made inaccessible via safety latch. The program uses the bathrooms (girls and boys) in the Main Building (located approximately a one-minute walk away) that afford privacy. Sign-in (manual) area is located directly upon entering the classroom. All required postings were posted. LPA provided additional Parent’s Right poster. Facility representatives were reminded to keep anything that reads, “Keep Out of Reach of Children” to be inaccessible to children. Ms. Roman was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

Personnel and children's records were reviewed. LPA reviewed sign in/out sheets, a sample of personnel records and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. Children are evaluated upon entry and monitored throughout the day for signs of illness. CONTINUED ON PAGE 2
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: YMCA TEENS IN MOTION: RANCHO BERNARDO HIGH
FACILITY NUMBER: 376105068
VISIT DATE: 10/15/2024
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The isolation area for ill children awaiting pick up is directors area inside or the outside bench area. Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.


All personnel have required criminal record and child abuse index clearances. All staff members have the required immunizations and have completed mandated child abuse training. LPA reviewed Emergency Disaster Plan and the last emergency drill was conducted on 8/22/24. An updated roster was obtained during the inspection. Reporting requirements and AB633 was also reviewed.

Ms. Roman 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.

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. 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 has been 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.

Child Care Providers can now sign up for Quarterly Updates and PINS through the CDSS website. Please go to www.ccld.ca.gov and click on “Receive Important Updates,” then enter your email address and choose which program you would like to subscribe to and click subscribe.


CONTINUED ON PAGE 3
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: YMCA TEENS IN MOTION: RANCHO BERNARDO HIGH
FACILITY NUMBER: 376105068
VISIT DATE: 10/15/2024
NARRATIVE
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No deficiencies sited.

Exit interview conducted and report was reviewed with Selena Roman, site director. A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
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