304371223-5-13-2024-06-CC-PRIS-D58QUV-20240513122922

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371223
Report Date: 05/13/2024
Date Signed: 05/13/2024 12:31:03 PM

Document Has Been Signed on 05/13/2024 12:31 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	YMCA-ESENCIA		FACILITY NUMBER:	304371223
ADMINISTRATOR/ DIRECTOR:	TABAREZ, JOSE		FACILITY TYPE:	840
ADDRESS:	5 APRENDER STREET		TELEPHONE:	(949) 380-3521
CITY:	RANCHO MISSION VIEJO	STATE: CA	ZIP CODE:	92694
CAPACITY: 200	TOTAL ENROLLED CHILDREN: 200	CENSUS: 7	DATE:	05/13/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:10 AM
MET WITH:	Jose Tabarez,Site Supervisor, Applicant Rep		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 05/13/24 at 9:00am, Licensing Program Analyst (LPA) PRivas conducted an unannounced Case Management inspection for an increase in capacity to 350 school age children. Upon arrival, LPA met with Applicant/Facility Rep Jose Tabarez. The facility is within Esencia Elementary within the Capistrano Unified School District. Applicant is requesting to be licensed for 350 school age children from tk-8th grade in classrooms F103, F104,F107, F108, F109, Portables 1 and 2, C103, C104, C105, P2, P3 & Innovation Center. Hours of operation will be 6:45am to 6:00pm (school starts at 8:00 and 9:30am for TK; Monday to Friday. ) Present during today’s inspection were (7) children with (2) staff. Appropriate ratios and supervision were observed. All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Jose Tabarez that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. LPA continued to tour the facility. Since facility is located within a public school,

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA-ESENCIA	FACILITY NUMBER: 304371223
	VISIT DATE: 05/13/2024

NARRATIVE

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measurement was not conducted. LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, bookshelves, and other activity supplies for the children. Drinking water is available in the classrooms via water filter system and they bring their own water bottles. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 03/20/24 with following special conditions; Innovation Center limited to 326 occ an open room set up or 152 occ if set up with tables and chairs. Applicant Representative Jose Tabarez indicates that the Innovation room is mainly used as a library with tables and chairs .

LPA observed a total of 33 sinks and 28 toilets/urinals available for children’s use. These are sufficient to accommodate the requested capacity of (350) children. Bathrooms in Building C, Building D, Building F each with two sinks in girls and boys bathroom(12 sinks); girls bathrooms with 3 toilets, boys bathrooms 1 toilet and 2 urinals (12 toilets/6urinals for C, D & F Buildings). Cafeteria Bathrooms, each with 3 sinks total 6 sinks, Girls bathroom had 5 toilet and boys bathroom had 3 urinals and 2 toilets. There is a sink in Rooms F104, F107, F108, F109,C104, C105; C103; F103 had 9 sinks,

The facility currently has 2 fully fenced playground areas. Fencing (chain link is at least four feet high) One is called Big Toy Playground, the other playground is the

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA-ESENCIA	FACILITY NUMBER: 304371223
	VISIT DATE: 05/13/2024

NARRATIVE

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Kinder yard playground. Shade is provided via overheads awnings. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. There is a climbing structure on the playground for children ages (5 to 11) which is properly anchored on Big Toy Playground. The play structure on the Kindergarten area did not have a sticker for age use but was smaller than the one on the Big Toy Area. There is adequate cushioning in fall zones of climber provided by pour and play. Drinking water is i.s available via (water filter system and children also bring their own bottles of water) LPA observed all hazardous items on the playground to be inaccessible to children. Applicant, Jose Tabarez was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). Applicant advised that the building was built in 2017.

LPA was provided an updated sketch, lic 500 and letter from principal for proof of control of property.
Final review will be conducted prior to licensure.

“LPA discussed with representative the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.”

Facility representative, Jose Tabarez was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YMCA-ESENCIA	FACILITY NUMBER: 304371223
	VISIT DATE: 05/13/2024

NARRATIVE

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care and supervision to children, and staff who have contact with children, 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.”

“Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication

Jose Tabarez was informed of the MyChildCarePlan.org site, 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.

A notice of site visit was given to facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the facility representative, Jose Tabarez

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

LIC809 (FAS) - (06/04)

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