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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371492
Report Date: 12/16/2022
Date Signed: 12/16/2022 10:51:33 AM

Document Has Been Signed on 12/16/2022 10:51 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:YMCA OF GREATER WHITTIER-RANCHO PRESCHOOLFACILITY NUMBER:
304371492
ADMINISTRATOR:RIVERS, JAMILAFACILITY TYPE:
850
ADDRESS:14540 SAN CRISTOBA DRIVETELEPHONE:
(951) 334-5622
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY: 29TOTAL ENROLLED CHILDREN: 29CENSUS: 5DATE:
12/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Jamila Rivers, Director TIME COMPLETED:
10:30 AM
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Licensing Program Analyst Mila Quinto conducted an unannounced Case Management visit. LPA met with staff, Rosie Gomez. There were 5 preschool children and 2 preschool staff. At 9:40am, Director Jamila RIvers arrived at the facility and discussed the Lead Sampling Testing conducted on 10/29/22. Director was advised on 12/16/2022 that the Lead Sample Report was to be posted. LPA confirmed that Director had posted the Lead Sample Report.

Director stated the outlet D and G are not being used for the preschool children. Outlet D is located in the other building and outlet G located in the staff breakroom also located in the other building are not being used for the preschool classroom.

Based on LPAs observation, there was no deficiencies found.

Exit interview conducted and report was reviewed with the Director, Jamila Rivers. A notice of site visit was given and must remain posted for 30 days.



Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) 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. First level appeals should be sent to the regional manager to the address listed above
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2022
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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