376600371-8-18-2023-51-CC-KLAE-CUTM4U-20230818091718

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600371
Report Date: 08/18/2023
Date Signed: 08/18/2023 09:17:28 AM

Document Has Been Signed on 08/18/2023 09:17 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	MISSION VALLEY YMCA - LONGFELLOW ELEMENTARY SCHOOL		FACILITY NUMBER:	376600371
ADMINISTRATOR:	REGAN SALAS		FACILITY TYPE:	840
ADDRESS:	5055 JULY STREET		TELEPHONE:	(619) 276-4206
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY: 125	TOTAL ENROLLED CHILDREN: 125	CENSUS: 0	DATE:	08/18/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Regan Salas & Lucelyna Godwin		TIME COMPLETED:	09:35 AM

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On 8/18/23 at 8:30 AM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced case management inspection at Licensee’s request. This school-age program is located on the Longfellow Elementary school site. Licensee is requesting a capacity increase from 125 to 153 for children in UTK through 12 years of age. Licensee is adding rooms auditorium and B-13 to the license. Upon arrival, LPA met with Site Supervisor Regan Salas, Association Program Specialist Lucelyna Godwin and toured the facility. Also present was YMCA Coordinator Emilie Hayes. School starts on Monday, April 21^st, 2023 so no children were on campus during the inspection.

During this visit, LPA inspected new classrooms auditorium and B-13 which are to be added to the license. LPA also inspected currently licensed rooms: ISS/605, Library/601, B10 and B11. Fire clearance was granted 8/16/23. First Aid Kit/Medication is located in Room ISS/605 but every classroom will have a smaller first aid kit with each teacher. Epi-pens and inhalers are put in a bag with portable first aid kit for each classroom. Other medication is kept inaccessible to children in room 605 in a locked box in latched cabinet and locked medication box in the refrigerator. This school is a fully locked school and there are no parents allowed on campus. If parents wish to observe they must contact the office and will be given a badge. Sign-in is located at the track/field gate and sign outs are located at the 1^st grade cone zone gate.

(continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MISSION VALLEY YMCA - LONGFELLOW ELEMENTARY SCHOOL	FACILITY NUMBER: 376600371
	VISIT DATE: 08/18/2023

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Per H&S Code 1596.806, facility is exempt from square footage, toilet, isolation space, outdoor activity space and fencing requirements. All indoor and outdoor activity spaces utilized for the school age children were inspected. Rooms ISS/605, Library/601, B10, B11, B-13 and auditorium were observed to have age-appropriate furniture and equipment, including tables, chairs, bookshelves and other activity supplies for the children. LPA observed separate bathrooms with privacy.

There is a separate bathroom utilized for ill children in the nurse’s office located by the auditorium. There is an operational carbon monoxide detector located in ISS/605 classroom. Snack menu is posted, as well as all other required documents. LPA observed snacks/food preparation area and observed to be free of rodents and/or vermin. Snacks are located in classroom ISS/605 as well as refrigerator location. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 F or less.

The outdoor playground area was inspected. Area has building overhang and lunch area for shade. LPA observed blacktop area for playground. Site Supervisor stated they divide the blacktop into 3 areas for different age children. The daycare children are not allowed to use the playground structures. Drinking water is readily accessible inside and outside the classroom via water bottles the children bring. If a child forgets water bottle, they can get water bottles from the office and there are cups and sink in each classroom. Facility representative is reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

No deficiencies were cited at this inspection.

Upon final file review, Rooms Auditorium and B-13 may be approved for use by the facility and added to the license. Exit interview conducted and report was reviewed with facility representative Association Program Specialist Lucelyna Godwin. A notice of site visit was provided and must remain posted for 30 days.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

LIC809 (FAS) - (06/04)

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