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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701131
Report Date: 10/20/2022
Date Signed: 10/20/2022 11:42:20 AM

Document Has Been Signed on 10/20/2022 11:42 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:CRISTINA JIMENEZFACILITY TYPE:
850
ADDRESS:4300 EL CAJON BOULEVARDTELEPHONE:
(619) 280-9622
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 71TOTAL ENROLLED CHILDREN: 71CENSUS: 36DATE:
10/20/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Assistant Director Anay Barajas-LeonTIME COMPLETED:
10:50 AM
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On October 20th, 2022 at 9:35 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a case management inspection to follow-up on an incident that occurred on 10/13/2022. LPA advised Assistant Director Anay Barajas-Leon of the meeting’s purpose and was granted facility entry.

The facility serves children ages 2 – 5 years. The following ratios were observed in 4 classrooms: Room 1 was empty. Room 2 had thirteen (13) children (aged 2-3 years) supervised by two (2) teachers. Room 3 had thirteen (13) children (age 3-4 years) supervised by two (2) teachers. Room 4 had ten (10) children (age 4- 5 years) supervised by two (2) teachers.

On 10/13/2022 and 10/14/2022, the facility self reported an incident which occurred on 10/13/2022. On 10/13/2022, at about 8:17 – 8:20 AM, Child 1 (C1) left their classroom and was alone in the preschool hallway until returned to their classroom by Staff 1 (S1). (See LIC 811 Confidential Names). C1's parent had just dropped off the child inside their classroom and left the site. While S1 spoke with another parent, C1 left their classroom to follow their parent to give them a "tickle hug", but the parent was already gone from the center. It was reported that seconds later S1 noticed C1's absence, thus they opened the room's door and found C1 standing alone in the preschool hallway outsider. The director reported there are no cameras in the preschool hallway. Visual observation of the preschool hallway confirmed no cameras in the preschool hallway.



S1 reported that on 10/13/2022, at about 8:17 AM, S1 was alone in the classroom with 3-4 children. A group of three (3) families, including C1, were dropped off inside the classroom at about 8:17 AM by their parents. A parent spoke with S1 towards the other side of the room for a short conversation. At the start of this conversation, S1 saw C1 at the front end of the classroom. S1 looked away for a short period, approximately 1 - 2 seconds and saw C2 gone. S1 opened the classroom door and saw C1 about 10.3 yards (372 inches
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2022
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: COPLEY-PRICE FAMILY YMCA PRESCHOOL CHILD CARE
FACILITY NUMBER: 376701131
VISIT DATE: 10/20/2022
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away towards the door which leads to the playground. The child returned to the classroom.

Due to insufficient information available at this time, further investigation is needed.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Assistant Director Anay Barajas-Leon.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
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