376300570-8-4-2022-10-CC-ANOE-CGYRUV-20220804132033

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376300570
Report Date: 08/04/2022
Date Signed: 08/04/2022 01:20:46 PM

Document Has Been Signed on 08/04/2022 01:20 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	MOTTINO FAMILY YMCA - BELLA MENTE ACADEMIES		FACILITY NUMBER:	376300570
ADMINISTRATOR:	SMEAD, COURTNY		FACILITY TYPE:	840
ADDRESS:	1737 W VISTA WAY		TELEPHONE:	(619) 873-7134
CITY:	VISTA	STATE: CA	ZIP CODE:	92083
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 0	DATE:	08/04/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:38 AM
MET WITH:	Lucelyna Godwin		TIME COMPLETED:	01:40 PM

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 11:38 am, Licensing Program Analyst (LPAs), Ana Noble and Jessica Rubio conducted a pre-licensing inspection this date for a proposed School Age. The days and hours of operation will be: Monday 6:30 am-10:00 am/2:45 pm -6:00 pm, Tuesday-Friday 6:30 am -9:45 am/2:45 pm-6:00 pm. LPAs met with Lucelyna Godwin who led a tour of the facility at 12:05 PM. Fire Clearance was granted on 6/29/2022. Per Health and Safety Code Section 1596.806 the following applies: (a) A room used as a classroom by a school-age child care program shall not be required to meet the square footage or toilet requirements for child day care centers if the program is operated on either of the following: (1) A functioning school site in the same facilities that have housed school children during the day, before or after school hours, or before and after school hours. (2) A functioning school site in facilities certified as usable as a classroom for instruction. A building owned by a school district, the state, or the school-age child care program may meet the certification requirement if either of the following is provided to the department: (A) Evidence that the building was approved as a classroom by the office of the State Architect. (B) A certification statement signed by the superintendent of the schools, or his or her designee, in the district where the school-age child care program is located, that the classroom building is of sufficient size to accommodate public instruction. The school district may make this certification regardless of the ownership of the classroom. 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 dispenser and disposable cups, supply drinking water in the indoor activity space · Playground is enclosed by a wrought iron fence · Outdoor activity area is supplied with age and size appropriate equipment · There are no accessible bodies of water present. If wading pools or similar products are used, they must be emptied immediately after use and stored in an upright position.

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 - BELLA MENTE ACADEMIES	FACILITY NUMBER: 376300570
	VISIT DATE: 08/04/2022

NARRATIVE

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· An adequate amount of cushioning material rubber cushion material is in place under play equipment
· Adequate shade is provided by awning over the wooden benches.
· Drinking water is provided in the outdoor play area by drink fountain and water dispenser w/disposable cups.
· Food preparation area (for snack only) is equipped with refrigerator, sink with hot and cold running water, storage area, utensils, and adequate amount of food supplies.
· The office area is located near the entrance (Director will be located in Room 114 or 116).
· School Nurses 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 locked cabinet inside classroom #114/116 which is inaccessible to children
· Storage area for toxins and poisons is locked, located in storage shed on school campus.
· First Aid kit is complete with all required items.
· Sign in/Sign out record was reviewed and meets regulation requirements
· Parent Board located inside Classroom 116 with all required forms.
· Carbon Monoxide Detector located inside each classroom #114/116.

Limiting factor for School Age (SA) Program capacity is requested capacity of 40. The Fire Clearance granted on 6/29/2022. School Age Program capacity is limited to 40 School Age children.

During the inspection, the following was reviewed with Facility Representative, 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

· 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 Informatio

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 - BELLA MENTE ACADEMIES	FACILITY NUMBER: 376300570
	VISIT DATE: 08/04/2022

NARRATIVE

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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.

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

1. In the boys restroom there is 1 toilet stall that has no door and a urinal that is not properly working and requires cleaning which need to be corrected. Submit pictures as proof of correction to the Department.

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 - BELLA MENTE ACADEMIES	FACILITY NUMBER: 376300570
	VISIT DATE: 08/04/2022

NARRATIVE

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2. Make all the hazardous items located near the artificial turf/black top area inaccessible to the children.

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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