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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701126
Report Date: 05/19/2023
Date Signed: 05/20/2023 01:41:46 PM

Document Has Been Signed on 05/20/2023 01:41 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:YMCA - MCKINLEY ELEMENTARYFACILITY NUMBER:
376701126
ADMINISTRATOR:TAYLOR PLATTEFACILITY TYPE:
840
ADDRESS:3045 FELTON STREETTELEPHONE:
(619) 282-7694
CITY:SAN DIEGOSTATE: CAZIP CODE:
92104
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 0DATE:
05/19/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Taylor Platte
TIME COMPLETED:
02:35 PM
NARRATIVE
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On 05/19/23 at 2:30 p.m. Licensing Program Analyst (LPA) Cindy Meier conducted an unannounced case management inspection to follow up on the unusual incident reported to the Department on 12/12/22. Upon arrival, LPA met with Site Supervisor Taylor Platte and discussed the purpose of the inspection. LPA was led on a tour of the facility. No children or staff were present besides the Site Supervisor as the program had not started.

Based on interviews conducted, it was determined that on 12/09/22, Child #1 (C1) was left unattended in the classroom for approximately five (5) minutes when staff escorted the other children to the restroom. According to witnesses, C1 was sitting alone, outside the classroom, at the picnic tables when the staff and other children returned from using the bathroom.

Per California Code of Regulations, (Title 22, division 12 & Chapter 1) one (1) Type A citation is being cited on the attached LIC 809-D.

LPA Cindy Meier informed Site Supervisor, Taylor Platte, that this report dated 05/19/23 document(s) (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Cindy Meier informed the Site Supervisor, Taylor Platte to provide a copy of this licensing report dated 05/19/23 that documents Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2023
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: YMCA - MCKINLEY ELEMENTARY
FACILITY NUMBER: 376701126
VISIT DATE: 05/19/2023
NARRATIVE
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Exit interview conducted and report was reviewed with Site Supervisor, Taylor Platte. A copy of this report, along with Appeal Rights (LIC9058), were provided. A Notice of Site Visit was given and must remain posted for 30 days. LPA observed that the Notice of Site Visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/20/2023 01:41 PM - It Cannot Be Edited


Created By: Cindy Meier On 05/19/2023 at 01:54 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: YMCA - MCKINLEY ELEMENTARY
FACILITY NUMBER: 376701126

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/19/2023
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Responsibility for Providing Care and Supervision
The licensee shall provide care and supervision as necessary...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:

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Childcare Director and Site Supervisor will review current supervision procedures to ensure they cover visual supervision and transitions, along with conducting a staff in-service training that addresses the topics of visual supervision and transitions. Childcare Director and Site Supervisor will provide a written statement of these procedures, date and agenda of training to LPA by 05/23/23.
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Based on interviews conducted and records reviewed, the licensee did not comply with the section cited above, as C1 was left unattended in the classroom for approximately five (5) minutes which poses an immediate health and safety risk for children in care.
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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:Jason Garay
LICENSING EVALUATOR NAME:Cindy Meier
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2023


LIC809 (FAS) - (06/04)
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