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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701131
Report Date: 07/01/2024
Date Signed: 07/01/2024 11:14:38 AM

Document Has Been Signed on 07/01/2024 11:14 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:COPLEY-PRICE FAMILY YMCA PRESCHOOL CHILD CAREFACILITY NUMBER:
376701131
ADMINISTRATOR/
DIRECTOR:
CRISTINA JIMENEZFACILITY TYPE:
850
ADDRESS:4300 EL CAJON BOULEVARDTELEPHONE:
(619) 280-9622
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 71TOTAL ENROLLED CHILDREN: 71CENSUS: 34DATE:
07/01/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Cristina JimenezTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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On July 1, 2024, at 09:25 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a case management inspection to follow-up on an incident that occurred on 06/27/2024. LPA advised Director Cristina Jimenez of the meeting’s purpose and was granted facility entry. Director Jimenez provided LPA with a facility tour. The following ratios were observed in 3 classrooms: Room 2 had fourteen (14) children with two (2) staff members. Room 3 had eleven (11) children with two (2) staff members. Room 4 had nine (9) children with two (2)) staff members. LPA observed the children to be involved in indoor and outdoor activities. Appropriate ratios were maintained, and visual observation noted.

A child sustained an injury and required medical treatment on 06/27/2024. The incident was self reported by the facility. There were 14 children with 2 staff during the incident. On 06/27/2024, around 11:30 AM, a child slipped on the steps to the playground play structure and broke their left arm. Staff immediately attended to the child by elevating their arm and applying ice to the child's arm. Staff contacted that child's responsible representative. LPA inspected the play structure and observed the ground underneath it to be padded. LPA also observed that the equipment is age-appropriate. There were no apparent hazards accessible to children. Staff said that the involved child was running about the playground; they ran to staff crying about their arm. The involved child declined to speak with LPA. The child's responsible representative told LPA that per the child, they ran about the playground and slipped hitting their arm on the playground structure. The responsible party said that the child described the incident the same as what staff described the incident to the responsible party. No deficiencies cited.

A notice of site visit was given to facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Licensee/Appeal Rights (LIC 9058) was provided to Director Jimenez. Exit interview conducted and report was reviewed with the facility representative Director Cristina Jimenez.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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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