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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401223
Report Date: 07/31/2024
Date Signed: 07/31/2024 01:25:39 PM

Document Has Been Signed on 07/31/2024 01:25 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:YMCA OF METRO LA/NORTH VALLEY HARDINGFACILITY NUMBER:
197401223
ADMINISTRATOR/
DIRECTOR:		VERONICA ESPINOZAFACILITY TYPE:
840
ADDRESS:13060 HARDING STREET, #28TELEPHONE:
(818) 314-8819
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 27DATE:
07/31/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Veronica Espinoza, DirectorTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On Wednesday, July 31, 2024, at 9:35 am, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection and met with Director Veronica Espinoza who granted access and guided LPA Rivera on a tour of the facility.

This is a school -age program that serves children ages 4 to 11 years. This program operates Monday to Friday 7:00 a.m. – 6:00 p.m. (during summer break). School days 6:30am-8:00am (morning) and Monday, Wednesday, Thursday, and Friday 2:20 p.m.(dismissal) and Tuesday 1:20 pm (dismissal) to 6:30 pm. Sign in and out takes place at the main entrance area. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Teacher and child ratio were observed, and present staff are fingerprinted cleared and all staff have the pediatric first aid/ CPR certification. Annual fee is current.



At approximately 9:45 a.m., LPA Rivera reviewed children and staff files. LPA observed the files to be complete.

At approximately 11:15 a.m. LPA entered classroom Discovery. LPA Rivera observed 12 children present with staff #2 and staff #4 providing care and supervision. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed a cubby for children to store their personal belongings. LPA observed cleaning solutions stored inside a cabinet located in the bathroom. LPA observed the cabinet closed with a keypad lock making it inaccessible for children to open. LPA did not observe knives. Director stated the knives were removed from premises and fruit and vegetables are either pre-cut, frozen or whole fruit. LPA Rivera observed a step trash bin with a lid.

At approximately 11:30 a.m. LPA entered classroom Adventure. LPA Rivera observed 15 children present with staff #2 and staff #3 providing care and supervision. LPA observed age-appropriate furniture and
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY HARDING
FACILITY NUMBER: 197401223
VISIT DATE: 07/31/2024
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equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed a cubby for children to store their personal belongings. LPA observed cleaning solutions stored inside a cabinet located in the bathroom. LPA observed the cabinet closed with a keypad lock making it inaccessible for children to open. LPA Rivera observed a step trash bin with a lid.

Heating, lighting, and ventilation were evaluated by LPA Rivera. LPA observed central AC/heater and vents located on the ceiling. LPA observed the thermostats located in classrooms and temperatures to be between 70-71 degrees. LPA observed the. required 2A10BC fire extinguisher located in the classrooms with the valve on the green area indicating fully charged and serviced on 10/15/23. Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. Carbon monoxide detectors in classrooms and LPA tested the carbon monoxide located in the Discovery classroom. LPA heard the sound, and it is operable. The last emergency drill was conducted on 7/23/24. First aid kit supplies are kept inside the classrooms and LPA observed the kits to be fully equipped. During this visit, per director Veronica, stated currently has 2 children with medications and no severe food allergies. LPA observed medication for child #1 Albuterol expires 9/30/25 and for child #2 Albuterol expires 04/30/25. LPA Rivera asked if there were any poisons, firearms, weapons, or bodies of water. Director stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Director stated the ill isolation area takes place in a corner of the classroom and one of the restrooms is used for isolation once the isolated child uses that restroom.

LPA observed the restrooms located in the classrooms. LPA Rivera observed the restrooms to be in good condition with working toilets, sinks, hand soap dispenser and paper towels. LPA observed a total of 2 toilets and 2 hand washing sinks. LPA Rivera reminded director school-age children toilet facilities shall not be used simultaneously by children of both sexes and shall provide individual privacy.

At approximately 11:47 a.m. LPA Rivera inspected the outdoor play area utilized by children. The playground children utilize is the playground that belongs to Harding Elementary school. LPA observed the equipment to be in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed the playground to be fenced all around the gates closed with a keypad lock. LPA observed a climbing playground structure. Director stated the playground structure belongs to Harding Elementary school and YMCA children are not allowed to use the

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
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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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY HARDING
FACILITY NUMBER: 197401223
VISIT DATE: 07/31/2024
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structure. For outdoor water drinking, staff bring out water jugs and disposable cups and children bring out their water bottles hydro flask.

This program provides a.m., and p.m., snacks. Meals are provided by parents. LPA Rivera informed director Veronica any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. For water drinking, LPA Rivera observed water pitchers and disposable cups in the classrooms. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including moveable bins with tight-fitting covers that are kept on, and in good repair. The facility was observed to be free of flies, other insects, and rodents. LPA observed the refrigerator temperature to be at 35 degrees and did not observe expired food. Lead testing was conducted on 12/20/22 and no lead exceedance.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, and Daily Schedule. LPA Rivera observed sign in sheet and observed 27 signatures.


LPA Rivera observed director Veronica Espinoza American Heart Association Pediatric First Aid/CPR certification dated 9/10/23, Preventative Health and Safety certification dated 9/24/2016, lead 7/29/21and has proof of immunization against Pertussis, MMR, and Influenza declination. Director has completed the mandated reporter (AB 1207) training dated 9/29/2022. Director was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com
Items discussed during this visit with Director Veronica

1. The following items are prohibited by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.

2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
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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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY HARDING
FACILITY NUMBER: 197401223
VISIT DATE: 07/31/2024
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3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.

4.LIC 125- Entrance Checklist for CCC LPAs advised that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.

7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review.

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination

9.Children’s Records: must be available for review; including but not limited to, the following: Name, address, and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

10.Staff Records: must be available for review; background clearance, LIC 503 Health Screening report, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, Staff Qualifications, LIC 9050 Employee Rights, LIC 501 Personnel Record, AB 1207 Mandated Child Abuse Certification, MMR, TDAP, TB, influenza or influenza declination,

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YMCA OF METRO LA/NORTH VALLEY HARDING
FACILITY NUMBER: 197401223
VISIT DATE: 07/31/2024
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Director Veronica Espinoza was reminded that all adults 18 and over, 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-carecenters/.

Director Veronica Espinoza was informed of the MyChildCarePlan.org website; 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.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

No deficiencies given during this visit. A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview conducted and report and appeal rights were reviewed with Director Veronica Espinoza.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
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