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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191224046
Report Date: 01/10/2022
Date Signed: 01/10/2022 12:37:31 PM

Document Has Been Signed on 01/10/2022 12:37 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:VERDUGO HILLS FAMILY YMCAFACILITY NUMBER:
191224046
ADMINISTRATOR:SUZANNE MCMILLENFACILITY TYPE:
850
ADDRESS:6840 FOOTHILL BOULEVARDTELEPHONE:
(818) 352-3255
CITY:TUJUNGASTATE: CAZIP CODE:
91042
CAPACITY: 68TOTAL ENROLLED CHILDREN: 68CENSUS: 23DATE:
01/10/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Director, Chelsea Lawrence and Branch Manager, Annie Azizian TIME COMPLETED:
12:12 PM
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Licensing Program Analyst (LPA) Maddox met with Director, Chelsea Lawrence and Branch Manager, Annie Azizian today for the purpose of conducting a Case Management inspection for a capacity increase. During this inspection there were 23 PS age children present. Facility is currently licensed for 68 PS children, they are requesting to add a Toddler option located in the main building in a separate room (Purple Birds).

Measurement's taken today:
19 X 21 = 399/35 equals 11 children
With measurements taken, center can accommodate 11 toddlers.

During today's inspection, LPA observed a baby bouncer and baby walker present in the classroom, LPA informed staff these items are prohibited in any licensed facility.

Fire Clearance has been received for the capacity increase.
Needed before capacity increase is granted:
Staff will need to incorporate a sink in close proximity to the changing table, pay past due fees, and submit an updated outdoor play schedule for the Toddlers.

Staff asked about using portable play pens for sleeping, after reviewing Title 22 Regulations, the Regs mention cots or mats only. Staff was also informed they have pass due fees.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2022
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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