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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574501142
Report Date: 06/27/2024
Date Signed: 06/27/2024 01:27:37 PM

Document Has Been Signed on 06/27/2024 01:27 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:YMCA OF THE EAST BAY - WOODLANDFACILITY NUMBER:
574501142
ADMINISTRATOR/
DIRECTOR:		SANDRA TORRES HERNANDEZFACILITY TYPE:
860
ADDRESS:1285 LEMEN AVETELEPHONE:
(530) 668-9622
CITY:WOODLANDSTATE: CAZIP CODE:
95776
CAPACITY: 79TOTAL ENROLLED CHILDREN: 79CENSUS: 57DATE:
06/27/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Carla CooperTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Director of Operations Carla Cooper and Center Director Sandra Torres Hernandez for the purpose of a pre-licensing inspection. Licensee is requesting to add a toddler component for 16 toddlers ages 18-36 months and a decrease in capacity for the currently licensed preschool component for 63 children from age two years to entry into kindergarten for a total capacity of 79. The program currently operates Monday through Friday from 7:00 a.m. to 5:30 p.m. The fire clearance was granted and received on 5/3/2024. The facility currently provides breakfast, lunch, and afternoon snack.

LPA informed Director that the facility will be converted to a single child care center license under facility number 574501142, therefore LPA will be closing the current preschool facility number 573601607.

LPA reviewed with Director the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA discussed the safe sleep regulations with the Regional Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

INDOOR ACTIVITY SPACE:
There is one toddler classroom located in Room #3 and two preschool classrooms located in Room #1 A/B and Room #2. LPA observed a sufficient amount of equipment, toys, tables, chairs, and cubbies for all classrooms. LPA observed napping cots for the toddlers and preschool children. There is a first aid kit in each of the classrooms. Medications will be stored in each classroom in the medication backpack.

Report continues on LIC809-C page 2.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: YMCA OF THE EAST BAY - WOODLAND
FACILITY NUMBER: 574501142
VISIT DATE: 06/27/2024
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Page 2.

LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. LPA observed water jugs and cups in all classrooms and outdoors. LPA observed a functional carbon monoxide detector in the all classrooms. LPA observed an electronic sign-in/sign-out system.

LPA confirmed with Director that no structural changes have been made since licensure therefore LPA did not take measurements and used current measurements from report dated 2/28/1996. The toddler classroom (Room #3) contains a total of 665 square feet which will accommodate Licensee’s request for 16 toddlers. The preschool classroom spaces (Room #1 A/B and Room #2) contain a total of 3,519 square feet which will accommodate Licensee’s request for 63 preschool children. There are three toilets and three sinks located in Room #1 A/B, four toilets and three sinks located in between Room #2 and #3, and two sinks located in Room #3. There is a private restroom for staff located down the hall on the left side. Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property, Toddler Yard/Toddler Patio and Preschool Yard. The outdoor play area is fenced with a wrought iron fence that is at least four feet tall and separates the preschool yard from the toddler yard. LPA observed a sufficient amount of equipment and toys. There is one small play structure on the Preschool Yard which is designated for ages 2-5 years old. There are no bodies of water on the premises. There are shaded areas supplied by trees, a canopy, and overhangs.

LPA measured the Toddler Yard and Toddler Patio. The toddler outdoor space contains a total of 1,421 square feet which will accommodate Licensee’s request for 16 toddlers. LPA measured the Preschool Yard. The preschool outdoor space contains a total of 7,343 square feet which will accommodate Licensee’s request for 63 preschool children.

Report continues on LIC809-C page 3.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: YMCA OF THE EAST BAY - WOODLAND
FACILITY NUMBER: 574501142
VISIT DATE: 06/27/2024
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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

LPA discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Director any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Director 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Director was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Report continues on LIC809-C page 4.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: YMCA OF THE EAST BAY - WOODLAND
FACILITY NUMBER: 574501142
VISIT DATE: 06/27/2024
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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.

Exit interview conducted and report was reviewed with Director of Operations Carla Cooper.

Effective today, 6/27/2024, LPA will approve the change of components served and change in capacity for 16 toddlers ages 18-36 months in Room #3 and 63 children ages two years to entry into kindergarten in Rooms #1 A/B and #2.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC809 (FAS) - (06/04)
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