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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700148
Report Date: 12/20/2023
Date Signed: 12/20/2023 09:06:12 AM


Document Has Been Signed on 12/20/2023 09:06 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:LA JOLLA YMCA - LA JOLLA ELEMENTARYFACILITY NUMBER:
376700148
ADMINISTRATOR:ERIC WHITEFACILITY TYPE:
840
ADDRESS:7337 GIRARD AVE.TELEPHONE:
(858) 454-7196
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY:75CENSUS: 0DATE:
12/20/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lycelyna Godwin and Dayna WhittyTIME COMPLETED:
09:15 AM
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On 12/20/2023 @ 8:30AM, Licensing Program Analysts (LPAs) Nancy Diaz and Sherlynn Banas conducted an announced case management inspection in reference to licensee's request to move back to the auditorium. LPAs met and toured the facility with Lycelyna Godwin (Program Specialist) and Dayna Whitty (Program Director).

During this inspection, LPAs observed age-appropriate supplies and equipment. Required forms were observed posted on the wall, visible to authorized representatives. Facility has first aid kit available on site. Bathrooms were observed available for children's use. Facility has designated bathroom for ill children in the nurse's office.

Outdoor play areas were observed today. Trees and outdoor canopies will provide shade during outdoor activities. Hours of Operation is: 6:30am to 8:15am; 2:40pm to 6pm (Monday, Tuesday, Thursday & Friday); Wednesday 12:15pm to 6pm.

Children may utilize the auditorium upon receipt of Fire Marshall clearance.

Exit interview was conducted with Lycelyna Godwin. Copy of this report was provided today.
SUPERVISOR'S NAME: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 929-2327
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023
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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