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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600051
Report Date: 07/29/2024
Date Signed: 07/29/2024 11:00:50 AM

Document Has Been Signed on 07/29/2024 11:00 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:SOUTH BAY FAMILY YMCA-CHULA VISTA HILLS ELEMENTARYFACILITY NUMBER:
376600051
ADMINISTRATOR/
DIRECTOR:		BLANCA RINCONFACILITY TYPE:
840
ADDRESS:980 BUENA VISTA WAYTELEPHONE:
(619) 482-7066
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 0DATE:
07/29/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Miriam MartinezTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 7/29/24 at 9:30 a.m., Licensing Program Analyst (LPA), Adrian Castellon arrived at the facility to conduct a case management - License initiated inspection. Upon arrival LPA, met with Department Head Miriam Martinez and proceeded to inspect classroom #302. Also present was Program Coordinator Natalie Valle and Site Supervisor Destiny Ortiz. The facility has requested the addition of classroom #302 as part of the after school program. The capacity (70) will remain the same. Facility plans to operate in classroom #302 Monday through Friday from 5:00 p.m. to 6:00 p.m. for pick up purposes only. Classroom #705 is currently approved and used for daycare purposes.

A Chula Vista Fire Department report dated 7/19/24 was received by the SDCCRO approving use of classroom #302.

Classroom #302 was inspected and measured on this date. The classroom measures a total of 738 square feet (after deducting encumbered space). The outdoor playground was previously measured. The classrooms are equipped with age appropriate furniture and play equipment, tables, chairs, cubbies, bookshelves, and other materials for the children’s use. The classroom was observed to be orderly, free of hazards and has adequate heating, lighting and ventilation. The number of toilets and sinks is sufficient to accommodate the current capacity of children. The restrooms and hand washing areas were observed to be in safe, sanitary and operating condition. Uncontaminated drinking water is readily available during indoor and outdoor activities through the use of personal water bottles brought from home and classroom water fountain. Students will be provided an afternoon snack. The isolation area is the previously licensed auditorium.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2024
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: SOUTH BAY FAMILY YMCA-CHULA VISTA HILLS ELEMENTARY
FACILITY NUMBER: 376600051
VISIT DATE: 07/29/2024
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The outdoor activity spaces surface is observed to be free of hazards. There is a shaded area available during outdoor play. There is no evidence of rodent or insect activity.  Proper supervision and placement of staff during outdoor activities was advised to ensure the supervision and the safety of children. 

This facility may provide 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. 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 following reports were discussed and provided during the inspection: LIC809 reports and Appeal Rights (LIC9058).  After final file review, classroom #302 may be used for child care purposes. Once licensed the license will be mailed to the facility and upon receipt shall be posed in a prominent place in the facility. Exit interview conducted with facility staff.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
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