376300488-8-4-2022-10-CC-ANOE-CGYNW2-20220804104848

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376300488
Report Date: 08/04/2022
Date Signed: 08/04/2022 10:52:42 AM

Document Has Been Signed on 08/04/2022 10:52 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	MOTTINO FAMILY YMCA PRESCHOOL		FACILITY NUMBER:	376300488
ADMINISTRATOR:	RUSSELL, KRISTA		FACILITY TYPE:	850
ADDRESS:	4701 MESA DRIVE		TELEPHONE:	(619) 873-7134
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92056
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 0	DATE:	08/04/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:37 AM
MET WITH:	Lucelyna Godwin		TIME COMPLETED:	11:05 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 August 4, 2022 at 8:37 am, Licensing Program Analysts (LPAs), Ana Noble and Jessica Rubio conducted a pre-licensing inspection for a proposed Preschool Program. The days and hours of operation will be: Monday-Friday 8:00 am - 4:30 pm. LPAs met with Lucelyna Godwin, Licensee who led a tour of the facility at 09:06 AM. Fire Clearance was granted by the Fire Department on 7/26/2022. The facility was toured inside and out, and the following was observed: · Classrooms are adequately equipped with age and size appropriate furniture and equipment · Water, supply drinking water in the indoor activity space will be available in Water Dispenser and Personal Container/Disposable cups. · Playground is enclosed by a chain link fence · Outdoor activity area is supplied with age and size appropriate equipment · There are 2 community pools present (1 is empty and not being used and 1 that is full with water) that will only be used by the YMCA and program will have no access to the pools/bodies of water. If wading pools or similar products are used, they must be emptied immediately after use and stored in an upright position. · An adequate amount of cushioning material, artificial turf is in place under play equipment. · Adequate shade is provided by canopies. · Drinking water is provided in the outdoor play area by water dispenser and disposable cups/personal water containers. · Food preparation area is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies (kitchen is not located inside the classroom and is also used by the YMCA Programs. (Snacks will be stored in the classrooms) · The office area is located near the entrance · Director's office will serve as the isolation area for ill children temporarily until parents arrive · There is a working telephone located in the facility. · Medication will be stored in the child's assigned classroom in locked cabinet and inaccessible to children.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MOTTINO FAMILY YMCA PRESCHOOL	FACILITY NUMBER: 376300488
	VISIT DATE: 08/04/2022

NARRATIVE

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· Storage area for toxins and poisons is locked, located in outdoors storage containers.
· First Aid kit is complete with all the required items.
· Sign in/Sign out record was reviewed and meets regulation requirements
· Parent Board located in hallways between Room 1 and Room 2 with all required forms.
· Carbon Monoxide Detectors located in both classroom 1 & 2.

Measurements were taken and the following was determined:

Indoor Activity Areas-Room 1 and 2
LPA has determined that there is sufficient space to accommodate 40 children.

School-age Bathroom Fixtures
3 toilets x 15 = 45 children
3 sinks x 15 = 45 children

Outdoor Activity Area:
LPA has determined that there is sufficient space to accommodate 40 children. A waiver for shared playground/outdoor activity space is pending approval (with licensed school age program on site #376700327).

Limiting factor is requested amount of 40 Children. The Fire Clearance granted on 7/26/2022.
Preschool capacity is limited to 40 children.

During the inspection, the following was reviewed with Facility Representative/Designee Lucelyna Godwin:
· Component II Orientation was completed
· The applicant was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The importance of checking for recalled infant (children) devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant (children) devices with the CPSC to be notified of any recalls on their purchased equipment.

· Provider Information Notice (PIN) 22-20-CCP: Resources and Requirements on Lead Testing in Child Care, was provided to Licensee.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MOTTINO FAMILY YMCA PRESCHOOL	FACILITY NUMBER: 376300488
	VISIT DATE: 08/04/2022

NARRATIVE

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· LPA reviewed Incidental Medical Services (IMS). For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department if the facility will provide the services. 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
· The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

Facility representative Lucelyna Godwin was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A review of staff records on 8/3/2022 indicates that the applicant and/or designated individual who is required to have caregiver background checks have received criminal record and child abuse index clearances or exemptions. The applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

LPA reviewed with Facility representative the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MOTTINO FAMILY YMCA PRESCHOOL	FACILITY NUMBER: 376300488
	VISIT DATE: 08/04/2022

NARRATIVE

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The following items need to be completed prior to a license being issued:

1. Waiver for shared playground with Licensed School Age children.

LPA Noble will case review information with management regarding the 2 community pools (1 empty and 1 filled with water) on site and will follow up with Licensee, Lucelyna.

Once all corrections have been made, with proof sent to licensing, the application will be submitted for approval with a maximum capacity of 40 children. As agreed upon by facility representative, Lucelyna Godwin, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application will be denied. Exit interview conducted and report was reviewed with Facility representative Lucelyna Godwin.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2022

LIC809 (FAS) - (06/04)

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