197405353-1-22-2025-58-CC-LHEZ-DD73G4-20250122171344

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197405353
Report Date: 01/22/2025
Date Signed: 01/22/2025 05:13:55 PM

Document Has Been Signed on 01/22/2025 05:13 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	YMCA OF METRO LA/EAST VALLEY TOLUCA LAKE		FACILITY NUMBER:	197405353
ADMINISTRATOR/ DIRECTOR:	ELIZABETH GARCIA		FACILITY TYPE:	840
ADDRESS:	4840 CAHUENGA BLVD.		TELEPHONE:	(310) 486-6899
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91601
CAPACITY: 61	TOTAL ENROLLED CHILDREN: 45	CENSUS: 33	DATE:	01/22/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:45 PM
MET WITH:	Monique Otero, Seniro Director		TIME VISIT/ INSPECTION COMPLETED:	05:20 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	Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced annual inspection to the above facility on 01/22/2025. LPA arrived at the facility at 1:45PM, identified self and met with Monique Otero, Director, who guided analyst on a tour of the facility. LPA provided Director with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a school age program located at Toluca Lake Elementary School. LPA observed YMCA to have their own assigned bungalow with its own entrance located near the elementary outdoor yard. Per Director, days and hours of operation are Monday, Wednesday, Thursday, and Friday from 2:00pm to 6:00pm; Tuesdays from 1:00pm to 6:00pm. All areas identified on the Facility Sketch were inspected. LPA toured the facility indoors and outdoors and a census was taken. There were 33 children under care and supervision of the Director and 4 other staff members. The facility was observed to be within the license capacity and limitations. Director was reminded that all adults 18 and over, 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. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Tables and chairs meet the needs of the children in care. LPA observed a carbon monoxide detector located in the classroom. LPA was able to hear a successful test of the carbon monoxide detectors. ---Page 1 of 4

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA/EAST VALLEY TOLUCA LAKE	FACILITY NUMBER: 197405353
	VISIT DATE: 01/22/2025

NARRATIVE

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Outdoor area was observed to be located just outside the bungalows. Outdoor area was observed to be black top with four square court, handball courts, and kickball diamond. Outdoor area was observed to be free of any hazards.

Facility is located on a Los Angeles Unified School District (LAUSD) campus, pest control is provided by LAUSD. LPA observed the facility to be free of flies, insects and rodents. No poisons were observed in today’s inspection.

Disinfectants, cleaning solutions and other hazardous items were observed to be inaccessible and stored in locked classroom closet. Door of closet was observed to be labeled Chemical Storage.

All toilets and handwashing facilities are in safe and sanitary operating condition. Facility has separate restrooms for both sexes. Toilets used by school-age children provide individual privacy. Floors in the facility are clean and safe.

Facility does not have access to a kitchen. LPA observed snacks stored in a cabinet inside the classroom. All food is protected against contamination and any contaminated food is discarded immediately. Facility was observed with a refrigerator that was observed to be clean with thermometers, facility was observed with an up to date completed refrigerator temperature daily inspection log. Solid waste storage containers have tight-fitting covers and are in good repair.

Drinking water is available both indoors and outdoors with use of a water container. Children have water bottles, and the facility has disposable cups available.

Facility has conducted water lead testing to comply with Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA/EAST VALLEY TOLUCA LAKE	FACILITY NUMBER: 197405353
	VISIT DATE: 01/22/2025

NARRATIVE

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LPA observed the following postings on the parent board located on the wall of the classroom: Facility License, LIC 613A (9/96), the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster, LIC 610 Emergency Disaster Plan with the telephone number of the local health department, information on child passenger restraint systems, and a contingency plan for action during fires, floods and earthquakes. Menu was observed on the parent board. LPA observed disaster drill log posted on the parent board showing facility conducted a disaster drill on 08/22/2024.

LPA reviewed a sample of children’s files and observed files to be complete. YMCA uses an electronic document system. A printed copy of all electronic files was available for view. LPA reviewed facility medication policy with Director, there were no medications observed at the facility during the time of this inspection. Per Director, no children are currently taking medication. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. LPA observed sign out sheets with a section for parent/ guardian to sign out using a full legal signature.

LPA reviewed staff files show staff files to be complete with mandated reporter, immunization verification of Tdap, MMR, and flu, and health screening with TB clearance. Review of facility file shows Director has CPR/First Aid that expires 07/2025.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: YMCA OF METRO LA/EAST VALLEY TOLUCA LAKE	FACILITY NUMBER: 197405353
	VISIT DATE: 01/22/2025

NARRATIVE

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Director was informed of the MyChildCarePlan.org website; 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.

There were no deficiencies cited during today’s inspection.

A Notice of Site Visit was provided. The Notice of Site Visit must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview conducted and report was reviewed with Monique Otero, Director.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

LIC809 (FAS) - (06/04)

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