<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600265
Report Date: 02/24/2025
Date Signed: 02/24/2025 04:31:18 PM

Document Has Been Signed on 02/24/2025 04:31 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:EAST COUNTY FAMILY YMCA BENCHLEYFACILITY NUMBER:
376600265
ADMINISTRATOR/
DIRECTOR:		KAYLENE SHAKEFACILITY TYPE:
840
ADDRESS:6269 TWIN LAKE DRIVETELEPHONE:
(858) 531-4218
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY: 160TOTAL ENROLLED CHILDREN: 160CENSUS: 79DATE:
02/24/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:10 AM
MET WITH:Keturah LaneTIME VISIT/
INSPECTION COMPLETED:
04:45 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 2/24/25 at 3:10 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced case management inspection to follow up on an unusual incident reported by the facility that occurred on 12/17/24. According to the report submitted by the facility, a daycare child (C1) was found unattended outside the library by the parent upon pickup. This school-age program is on the campus of Benchley-Wineberger Elementary school. Upon LPA’s arrival to the licensed area of the campus, she was greeted by Interim assistant supervisor Janelle Ortiz and toured the classrooms. LPA observed a total of 79 children with 13 staff members in classrooms B4, 10, library, auditorium and outside on the playground. Site director Kaylene Shake arrived at 3:23 PM.

During this inspection, LPA interviewed two staff members. Based upon interviews with staff members and the incident report provided by the facility, C1 was left unattended for less than 5 minutes outside the library inside the campus. Parents of C1 were notified of the incident by the facility and LPA followed up with the parents. Since C1 was found shortly after a headcount by the staff inside the campus, a Type B deficiency was cited for a potential health and safety risk.

Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiency was cited (refer to LIC 809-D).

Exit interview conducted and report was reviewed with the facility representative, Director Kaylene Shake. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 02/24/2025 04:31 PM - It Cannot Be Edited


Created By: Keturah Lane On 02/24/2025 at 04:12 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: EAST COUNTY FAMILY YMCA BENCHLEY
FACILITY NUMBER: 376600265

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/24/2025
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
101229(a)(1) Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children’s needs. (1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation. This requirement was not met as evidenced by…
1
2
3
4
5
6
7
Director stated that they held a staff meeting on 12/19/24 with all staff present. Agenda and staff sign-in were e-mailed to LPA Lane on 2/24/25. Director also stated they are having a teacher by the door in B-4 when children are in the room. LPA provided proof of correction at the visit.
8
9
10
11
12
13
14
Based upon unusual incident report submitted by the facility and interviews with staff and parents, C1 was left unattended outside the classroom, by the library, for approximately 5 minutes or less which is a potential health, safety and personal rights risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Tashima Daniel
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2025


LIC809 (FAS) - (06/04)
Page: 2 of 2