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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701533
Report Date: 09/27/2022
Date Signed: 09/27/2022 07:32:27 PM

Document Has Been Signed on 09/27/2022 07:32 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:MISSION VALLEY YMCA - SACRED HEART PARISH SCHOOLFACILITY NUMBER:
376701533
ADMINISTRATOR:MARGARET GIUFFREFACILITY TYPE:
840
ADDRESS:706 C AVETELEPHONE:
(619) 298-3576
CITY:CORONADOSTATE: CAZIP CODE:
92118
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 0DATE:
09/27/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lucelyna GodwinTIME COMPLETED:
12:15 PM
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On 9/26/22 at 9:30am, Licensing Program Analyst (LPA), Martha Malane arrived at the facility to conduct a pre-licensing inspection. LPA met with licensee representative, Lucelyna Godwin, Site Supervisor, Margaret Guifree and Program Coordinator, Melanie Navarro and was led on a tour the facility. Applicant is requesting a capacity of 60 school age children (age 4.9-12 years) in the 2nd grade room and the library. Applicant will submit an updated LIC200A to reflect a capacity of 54 children due to indoor space. Applicant’s planned hours of operation are M/T/Th/F 2:30pm – 6:00pm and Wed. 1:00pm – 6:00pm.

The indoor space measured a total of 1919.43 square feet which is sufficient to accommodate 54 children. Classrooms are equipped with age appropriate furniture and equipment including tables, chairs, bookshelves and other materials for children. There are two (2) restrooms each containing one (1) toilet and one (1) sink next to the library, a girls’ restroom with six (6) toilets and three (3) sinks next to the front office, a boys’ restroom with five (5) toilets, five (5) urinals and two (2) sinks upstairs above the office and two (2) sinks in the library available for use, for a total of 15 toilets and nine (9) sinks which is sufficient to accommodate the requested capacity, Facility is requesting a waiver due to not having exclusive use of the restrooms. Drinking water is available outdoors and indoors via water stations, drinking fountains and refillable water bottles brought from home. A staff restroom located next to the nurse’s office will be utilized as an isolation restroom for children who are ill. The nurse’s office will be utilized for the isolation area if a child becomes ill. Disinfectants and cleaning solutions are kept in an inaccessible cabinet on the outdoor activity space. The facility utilizes manual sign in and sign out sheets. Required documents are posted. There is an operational carbon monoxide detector.

The outdoor activity space was inspected and measured a total of 14,149.22 square feet which is sufficient to accommodate 188 children. Facility is submitting a waiver request to share outdoor space with the elementary school. The outdoor space is fenced and shade is provided through the use of patio covers, trees and canopies. Proper supervision and placement of staff outside was discussed to ensure the safety of children at all times.
Continued See LIC809C…
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2022
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: MISSION VALLEY YMCA - SACRED HEART PARISH SCHOOL
FACILITY NUMBER: 376701533
VISIT DATE: 09/27/2022
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Water testing in Child Care Centers was discussed. Licensee representative was reminded that per AB2370, all Child Care Centers built after 2010 must have water tested for lead within 180 days of licensure. LPA provided PIN 21-21-CCP for water testing information and procedures.

A Fire clearance for 60 children (age 4.9 – 12 years) was granted 8/10/22.

Prior to licensure the following is needed:
1) Licensee representative stated they will submit a waiver request for shared use of restrooms
2) Licensee representative stated they will submit a waiver request for shared use of the library and 2nd grade class
3) Facility representative stated they will submit a waiver request for shared use of outdoor space

Exit interview was conducted with facility representative, Lucelyna Godwin. Once the listed requirements have been met, a license for 54 school age children (age 4.9 – 12 years) may be granted after a final file review.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022
LIC809 (FAS) - (06/04)
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