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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005598
Report Date: 11/15/2021
Date Signed: 11/15/2021 12:08:57 PM

Document Has Been Signed on 11/15/2021 12:08 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MAGDALENA ECKE YMCAFACILITY NUMBER:
372005598
ADMINISTRATOR:KARISA RIDDLEFACILITY TYPE:
850
ADDRESS:200 SAXONY ROADTELEPHONE:
(760) 942-9622
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 152TOTAL ENROLLED CHILDREN: 120CENSUS: 95DATE:
11/15/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:DIrector Karisa RiddleTIME COMPLETED:
12:15 PM
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On 11/15/2021 @ 10:50 a.m., Licensing Program Analysts, Joelle Redding and Daniel Pena, made an unannounced Case Management visit to complete the evaluation of the self reported incident that occurred on 11/1/2021.

During today's visit, LPAs spoke with children and Director for final follow up. Based on the evaluation of the circumstances surrounding the incident on 11/1/2021, staff physically restrained a child by sitting on the floor with arms around the child and legs over the child's legs, for a period of approximately 2 to 5 minutes as the child was throwing toys around the room, kicking and not responding to verbal direction. The child did not sustain any physical harm. There were three other children present in the room at the time of the incident.

A Type A deficiency will be cited on the accompanying LIC 809D. Note: Per Assembly Bill 633 (Parent Notification Requirements) the facility is to provide a copy of this Licensing Report to the parents of all children currently enrolled as well as any children newly enrolled over the next 12 month period. Parents are to sign form LIC 9224, Acknowledgment of Receipt of Licensing Reports and the form is to be kept in each child's file for Licensing's review. In addition, this Licensing report is to be posted along with the Notice of Site Visit for 30 days.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2021
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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Document Has Been Signed on 11/15/2021 12:08 PM - It Cannot Be Edited


Created By: Joelle Redding On 11/15/2021 at 10:14 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MAGDALENA ECKE YMCA
FACILITY NUMBER: 372005598

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/17/2021
Section Cited
CCR
101216,2

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Personnel Requirements. Child care center personnel shall be competent to provide the services necessary to meet the individual needs of children in care and shall at all times be employed in numbers sufficient to meet those needs.
This requirement was not met as evidenced by:
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Director states she has become the support person for the new teacher, providing options for her to employ so that she can meet the needs of all the children in care and ensuring that she is there to step in when needed. Director is researching training for all staff in managaging difficult behaviors to implement in the classrooms and is looking into options for
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Based on interviews, there is more than one child that takes additional attention due behavioral issues in this classroom. It does not appear staff was knowlegeable on how to manage the behavior and additional staff was necessary to meet the needs of all the children in the classroom. This is a potential hazard to the health and safety of children in care.
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ensuring that any one classroom doesn't have too many children who require individual attention that would take away from the other chidlren in the classroom. She will provide the agenda and staff roster upon completion of the training and, if she cannot get it completed by 12/17/21, she will ensure to have it at least scheduled by then.

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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:Renesha Pack
LICENSING EVALUATOR NAME:Joelle Redding
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2021


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/15/2021 12:08 PM - It Cannot Be Edited


Created By: Joelle Redding On 11/15/2021 at 10:16 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MAGDALENA ECKE YMCA
FACILITY NUMBER: 372005598

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/16/2021
Section Cited
CCR
101223.2

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Discipline. Any form of discipline or punishment that violates a child's personal rights as specified in Section 101223 shall not be permitted...

This requirement was not met as evidenced by
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Director states that Staff #1 was removed from the classroom and the school while investigation was done on the circumstances. She will not return to this particular classroom and a new teacher, who is familiar with the class and has managed the behaviors well prior has been put in place. Director is looking into finding training that addresses managing
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Based on interview and review of documentation. Staff #1 restrained Child #1 by putting her arms around the child and her leg across the child's leg in an attempt to stop the child from throwing toys and kicking he for approximately 3-5 minutes, causing the child to become distressed. This is an immediate hazard to the health and safety of children in care.
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difficult behaviors in the classroom and is in communication with the parents on a solution. All staff were reminded of the upcoming staff meeting this Wednesday, informing them that appropriate discipline will be reviewed. Director is support for the new teacher in the classroom and touches base with parents daily to know what to expect and plan for.

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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:Renesha Pack
LICENSING EVALUATOR NAME:Joelle Redding
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2021


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