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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105107
Report Date: 10/15/2024
Date Signed: 10/15/2024 01:44:29 PM

Document Has Been Signed on 10/15/2024 01:44 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:DAVIS FAMILY YMCA - GAGE ELEMENTARYFACILITY NUMBER:
376105107
ADMINISTRATOR/
DIRECTOR:		M. OVERLAND-MCKAYFACILITY TYPE:
840
ADDRESS:6811 BISBY LAKE AVENUETELEPHONE:
(619) 873-7134
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY: 175TOTAL ENROLLED CHILDREN: 175CENSUS: 0DATE:
10/15/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Breanna CastroTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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On 10/15/24 @ 1:00PM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced case management inspection. The purpose of this inspection is in reference to Licensee's request to add Rooms B8 and K4 to their existing license. Fire Marshall clearance was received on August 20, 2024.

LPA Nancy Diaz met and toured the classrooms with Site Supervisor Breanna Castro. Staff present today were Brianna Larios, Elizabeth Chavez, Brady Winn , Angelica Dixon & Juan Tapiz. There were no children present today.

Children currently utilize room #19, Auditorium and Library. Rooms B8 and K4 were observed equipped with age-appropriate equipments.

Corrections needed prior to licensure:
- Install latches on cabinets in Room K4 to make toxic items inaccessible to children.

Exit interview was conducted with Breanna Castro. A copy of this report and Notice of Site visit were provided. Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
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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