334841725-1-25-2022-09-CC-GCAO-CAZU53-20220125141604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334841725
Report Date: 01/25/2022
Date Signed: 01/25/2022 02:16:08 PM

Document Has Been Signed on 01/25/2022 02:16 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	CORONA-NORCO FAMILY YMCA YOUTH CENTER AT JURUPA		FACILITY NUMBER:	334841725
ADMINISTRATOR:	VOELTZ, MARTHA		FACILITY TYPE:	850
ADDRESS:	9254 GALENA STREET		TELEPHONE:	(951) 685-5241
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92509
CAPACITY: 164	TOTAL ENROLLED CHILDREN: 164	CENSUS: 34	DATE:	01/25/2022
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Art Cabrera,Director, Tammy Ellis, Regional Manager		TIME COMPLETED:	02:30 PM

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On 01/25/2021 at 11:30AM case management visit was conducted in response to the receipt of an unusual incident report (UIR) from the facility on 01/10/2022. It indicates a child scratched and hit staff and staff grabbed a child’s hands and feet.

Facility records were reviewed, and interviews were conducted with Associate Executive Director, Director and Teachers. According to staff interviews conducted facility policy is not to put hands on children and adopts a positive approach as outlined in Parent Handbook. Staff interviews revealed teachers may hold hands out flat to deflect kicks or punches towards them or to protect other children.

Based on information gathered, the facility acted appropriately, and no violations have been identified. Facility followed discipline steps as outlined in parent handbook which included: use of behavior intervention strategies (behavior contract, incentives, alternate activities, 1-1 assistance); Daily in person communication with parent and held behavioral conferences with parent to address behavior concerns. Facility also utilized company training (I Am Sam) and outside behavior consultant (MHConsultant) to assist with challenging behaviors.

An exit interview was conducted, and LPA Carbullido provided Art Cabrera, Director with a copy of this report and notice of site visit.

This report must be made available to the public upon request for three years.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022

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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