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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370042
Report Date: 02/20/2025
Date Signed: 02/20/2025 08:35:27 AM

Document Has Been Signed on 02/20/2025 08:35 AM - 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:SADDLEBACK VALLEY YMCA-LADERA RANCHFACILITY NUMBER:
304370042
ADMINISTRATOR/
DIRECTOR:		CHRISTINA PELLECCHIAFACILITY TYPE:
840
ADDRESS:29551 SIENNA PARKWAYTELEPHONE:
(949) 364-3089
CITY:LADERA RANCHSTATE: CAZIP CODE:
92694
CAPACITY: 120TOTAL ENROLLED CHILDREN: 144CENSUS: 1DATE:
02/20/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:50 AM
MET WITH:Christina PellecchiaTIME VISIT/
INSPECTION COMPLETED:
09:00 AM
NARRATIVE
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Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced case management incident inspection in response to a self-reported Unusual Incident dated 1/10/2025. LPA met with Director Christina Pellecchia. LPA observed one school age child with and one staff.

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. During the visit, it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.

On 1/10/2025, a self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported child #1 (C1), was left without adult supervision and found at the park located outside the school at 3:17 PM by C1 parent.

On 1/16/2025, LPA interviewed staff #1 (S1). S1 stated C1 arrived at the center on 1/9/2025, between 2:20 PM and 2:25 PM then met with staff #2 (S2). C1 asked S2 if they were supposed to be at the center and S2 informed C1 they were not supposed to be there. S2 then observed C1 walk out the school gate and into the park which is located next to the school and can be accessed through the gate from the school playground.

LPA asked S1, what is the protocol when a child arrives at the center and the child is not scheduled for the day. S1 stated “typically if a child is not supposed to be here and shows up, I am notified by staff but the day of the incident I was not notified.”

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SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SADDLEBACK VALLEY YMCA-LADERA RANCH
FACILITY NUMBER: 304370042
VISIT DATE: 02/20/2025
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Based on LPA observation from the school playground to the park and interview with S1, it was revealed that child (C1) was left alone on 1/9/2025, without any adult supervision. The child was left unattended for approximately 50 minutes until the parent observed C1 at the park. The following violation Responsibility for providing care and supervision was revealed today and is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, 101229 (a)(1) Responsibility for Providing Care and Supervision. Please see the attached LIC 809D.



LPA Thompson informed Director Christina Pellecchia that this report dated 2/20/2025, document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Thompson informed Director Christina Pellecchia to provide a copy of this licensing report dated 2/20/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Director Christina Pellecchia. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Appeal Rights and deficiencies were discussed. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/20/2025 08:35 AM - It Cannot Be Edited


Created By: Dean Thompson On 02/20/2025 at 08:07 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SADDLEBACK VALLEY YMCA-LADERA RANCH
FACILITY NUMBER: 304370042

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/20/2025
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.

This responsibility was not met by:
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Director stated as a plan of correction, staff attended trainings on supervision guildelines and accountability for absent children.

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Based on LPA observation from the school playground to the park and interview with S1, it was revealed that child (C1) was left alone on 1/9/2025, without any adult supervision. The child was left unattended for approximately 50 minutes until the parent observed C1 at the park which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Nguyen K Tran
LICENSING EVALUATOR NAME:Dean Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 02/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/20/2025


LIC809 (FAS) - (06/04)
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