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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300607120
Report Date: 02/26/2024
Date Signed: 02/26/2024 04:34:51 PM

Document Has Been Signed on 02/26/2024 04:34 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CAPISTRANO BEACH CITIES YMCA-AMBUEHLFACILITY NUMBER:
300607120
ADMINISTRATOR:SPABERG, JONASFACILITY TYPE:
840
ADDRESS:28001 SAN JUAN CREEK RD.TELEPHONE:
(949) 493-5327
CITY:SAN JUAN CAPISTRANOSTATE: CAZIP CODE:
92675
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 43DATE:
02/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:DirectorTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite inspection for the purpose of plan of correction. LPA met with director Jonas Spaberg in Y2 (210) who was supervising 32 school age children with 3 other staff. There were a total of 11 school age children in Y1 with 2 staff. The facility had been cited for teacher child ratio on 2/21/2023. The facility administrator submitted a plan of correction on 2/22/2024. At this inspection date, staff stated that they have been in ratio by adding additional staff. The director confirmed they follow the teacher child ratio since the last inspection. The facility is in compliance with teacher child ratio. LPA reviewed 4 staffs' files that were not present on the last inspection. They were in compliance. LPA checked the LIC 9224 (acknowledgement of receipt of licensing report) signed by parents. They were in compliance. The director showed a list of parents that received the reports.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 on this inspection. A notice of site visit was given to director Jonas Spaberg and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to post will result in Civil Penalties of $100.00.

Exit interview conducted and report was reviewed with the director Jonas Spaberg.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
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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