304371223-10-26-2021-06-CC-KDEI-C86TWZ-20211026150622

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371223
Report Date: 10/26/2021
Date Signed: 10/26/2021 03:06:31 PM

Document Has Been Signed on 10/26/2021 03:06 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	YMCA-ESENCIA		FACILITY NUMBER:	304371223
ADMINISTRATOR:	TABAREZ, JOSE		FACILITY TYPE:	840
ADDRESS:	5 APRENDER STREET		TELEPHONE:	(714) 508-7651
CITY:	RANCHO MISSION VIEJO	STATE: CA	ZIP CODE:	92694
CAPACITY: 184	TOTAL ENROLLED CHILDREN: 184	CENSUS: 0	DATE:	10/26/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator Tabarez, Jose		TIME COMPLETED:	03:25 PM

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Licensing Program Analyst (LPA) Desai, Ketki conducted an unannounced Case Management Licensee initiated inspection of the facility, for the purpose of increasing capacity from 184 children to 200 children and adding two new rooms (Innovation Center and Science /Computer room # F-103).

The facility is currently licensed for 184 children in rooms F-104, F-107, F-108, and F-109 since August 2019.

LPA met with on- site director, Jose Tabarez. Census was taken. There were no children present at the time of inspection as the school was still in session.

LPA inspected the 2 new rooms with director. (Innovation center and the Science/Computer Room # F-103), including the formerly approved rooms.

Facility also has requested a change in capacity increasing from 184 to 200 school age children ages 4.9 years, to 8th grade age.

The facility’s operating hours will be Monday through Friday from 6:45 AM to 6:00 PM during full day sessions and during regular school days, operating hours are from 6:45 AM to 8:00 AM and 12:00 PM to 6:00 PM. During the times when children are in school, there is a staff member on premises.

This YMCA new rooms are located on the Esencia public elementary/middle school site, Innovation center is attached to the Main Administrative building and the new Science/Computer room # F103 is in Building F next to the other licensed rooms. Administrative Office area is in the front of the parking lot.

The corner inside the Innovation center will serve as the isolation area for ill children temporarily until parents arrive. The staff bathroom will be used as the isolation bathroom and is conveniently located close to the Innovation center. First Aid kit is complete and placed in each classroom. The facility has electronic sign in/out in place.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA-ESENCIA	FACILITY NUMBER: 304371223
	VISIT DATE: 10/26/2021

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Due to current COVID pandemic situation, children are dropped and picked up at Gate # 1, there is table set up with a bell, upon ringing the bell, staff can receive the children and parents sign them off electronically. Temperatures are checked upon entrance and COVID protocols along with CDC and DPH guidelines are followed, during today’s inspection, staff were observed to follow the required guidelines.

Classrooms: Innovation center and Science / Computer room # F-103 were measured. Innovation center was measured: 3,364’64 sq. feet which accommodates 96 children, while Science computer room 1033’20 square feet which accommodates 29 children.

According to a letter sent from the school's principal, Innovation center has a maximum capacity of 487 children and Classroom # F-103 can accommodates maximum 46 children during school session.

School has granted permission for the program to utilize the facility restrooms and following have been designated Three toilets and 2 sinks from the girl's bathroom and one toilet, 2 sinks, and two urinals from the boy's bathroom for the program in building F. The facility has access to other three toilets, 2 sinks from the girl's bathroom and one toilet, 2 sinks, and two urinals from the boy's bathroom in building D. Innovation center has Two toilets , two urinals and three sinks in the boy’s restroom and five toilets and three sinks in the girl’s restroom. Facility has enough sinks/ toilets to accommodate the requested capacity.

The indoor activity space, outdoor space, and number of restrooms are exempt from licensing regulations.

Incidental Medical Service (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/(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

AM and PM snacks are provided by the facility, during full day session and PM snacks during half day sessions. Classrooms are adequately equipped with age and size appropriate furniture and equipment. Drinking water in the indoor activity space will be supplied by a drinking fountain in each classroom and personal water bottles.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA-ESENCIA	FACILITY NUMBER: 304371223
	VISIT DATE: 10/26/2021

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Playground area is completely fenced off. Outdoor activity area is supplied with age and size appropriate equipment including a structure with slides. There are adequate cushioning materials under the climbing structure Shade is provided by awnings. Drinking water for outdoor space will be provided by drinking fountain. Program has permission to utilize all the open green fields / play yards and shaded areas on the campus, with an approximate measurement of 16 acres of land.

The fire department has approved these new classrooms (Innovation Center and Science / Computer lab # F-103) along with four classrooms for 200 school age children.

An updated license for a capacity of 200 school age children will be issued for classrooms F-103, F-104, F-107, F-108, F-109 and Innovation center. Monday to Friday 6:45am -6:00 pm (Full day sessions) and 6:45 am – 8:00am / 12:00 pm – 6:00pm (Regular school days) for children 4’9 years to 8^th grade.

The Notice of Site Visit was posted. Facility representatives were informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

They were provided a copy of their appeal right (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

LIC809 (FAS) - (06/04)

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