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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701470
Report Date: 08/26/2024
Date Signed: 08/26/2024 09:54:32 AM

Document Has Been Signed on 08/26/2024 09:54 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:COPLEY-PRICE FAMILY YMCA-INFANT PROGRAMFACILITY NUMBER:
376701470
ADMINISTRATOR/
DIRECTOR:		CRISTINA JIMENEZFACILITY TYPE:
830
ADDRESS:4300 EL CAJON BOULEVARDTELEPHONE:
(619) 280-9622
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 13DATE:
08/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Cristina JimenezTIME VISIT/
INSPECTION COMPLETED:
09:05 AM
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On August 26, 2024 at 8:30 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an unannounced case management inspection to provide consultation on Provider Information Notice (PIN) 20-24-CCP Safe Sleep Regulations. LPA advised Director Cristina Jimenez of the inspection's purpose and was granted facility entry. There were eight (8) children (age 6 weeks to 24 months) in the Infant Room with three (3) staff members. There were five (5) children (ages 18 months to 24 months) in Room 1 with two (2) staff members.

LPA provided the director with PIN 20-24-CCP. Director and LPA discussed Safe Sleep Regulations. Director stated that infants are placed on their backs at the start of their naps; if they flip to their stomachs, staff may re-position them back onto their backs.

No deficiencies observed. 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 Director Cristina Jimenez.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2024
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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