YMCA-HAWES PROGRAM CENTER

Type A citation - immediate risk to health, safety, or personal rights

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Page 1 of 2 On 5/17/22 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management of the facility for an incident which was self reported by the facility representative to our office on 5/13/22. The Covid-19 Emergency Response questionnaire was answered. LPA met with director, Emily Perez.There were a total of 42 children and 4 staff including the director observed. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. According to the facility self report, it states: a 6 year old child was found out of the YMCA portable (Y2) unattended. A witness who was coming to the YMCA recognized the child and brought the child back to YMCA. Today LPA discussed the incident with the director, Emily Perez. LPA interviewed one staff, and four children who had knowledge regarding the incident. Staff # 1 stated that she was in the classroom with less than 12 school age children in Y2. Staff # 1 stated she did not notice the 6 year old child left the classroom but saw a witness brought the child back. Staff # 2 also stated she was in the room but did not see the child left. Staff # 2 saw a witness brought the child back to YMCA. Staff # 1 stated she was giving a 10 minutes break to the staff in charge of the 6 year old child.(staff # 3). It is not cleared how long the child was left unattended. According to staff # 1 this incident happened during the 10 minutes break of the staff # 3. Staff # 1 stated the absence of supervision must have occurred for couple of minutes. One child stated seeing 6 year od child got out of the classroom but could not tell for how long the child was gone. Child stated seeing the 6 year old came back with a witness. Three other children did not disclose any information. The incident happened around 4:45 pm. LPA attempted to contact the witness but no successful. LPA measured the Continued on page 2 SUPERVISORS NAME: Rina Lopez LICENSING EVALUATOR NAME: Mahnaz Malek LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY NAME: YMCA-HAWES PROGRAM CENTERFACILITY NUMBER: 300611774 VISIT DATE: 05/17/2022 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 26 27 28 29 30 31 32Page 2 of 2 distance from the classroom and the area the child was found. It was estimated 200 feet. Based on the information obtained through the staff # 1, staff # 2, and one child regarding the incident today, 6 year old child left the YMCA portable while the staff did not notice the child left. However the length of the time of absence of supervision is unknown. According to interviews the duration of absence might have happened couple of minutes. Section 101229(a)(1 Responsibility for Providing Care and Supervision Type A was cited on LIC 809D. An immediate civil penalty of 500.00 is hereby assessed for absence of supervision for today and 100.00 per day until corrected. Upon receipt of Type A violations, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility, and to the parents/guardians of children newly enrolled at the facility during the next 12 months. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. The Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Exit interview was conducted with director, Emily Perez. SUPERVISORS NAME: Rina Lopez LICENSING EVALUATOR NAME: Mahnaz Malek LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022 FACILITY NAME: YMCA-HAWES PROGRAM CENTER FACILITY NUMBER: 300611774 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 05/17/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 05/18/2022 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1)..........................1 2 3 4 5 6 7The director agreed to send a statement signed b

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Page 1 of 2 On 5/17/22 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management of the facility for an incident which was self reported by the facility representative to our office on 5/13/22. The Covid-19 Emergency Response questionnaire was answered. LPA met with director, Emily Perez.There were a total of 42 children and 4 staff including the director observed. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. According to the facility self report, it states: a 6 year old child was found out of the YMCA portable (Y2) unattended. A witness who was coming to the YMCA recognized the child and brought the child back to YMCA. Today LPA discussed the incident with the director, Emily Perez. LPA interviewed one staff, and four children who had knowledge regarding the incident. Staff # 1 stated that she was in the classroom with less than 12 school age children in Y2. Staff # 1 stated she did not notice the 6 year old child left the classroom but saw a witness brought the child back. Staff # 2 also stated she was in the room but did not see the child left. Staff # 2 saw a witness brought the child back to YMCA. Staff # 1 stated she was giving a 10 minutes break to the staff in charge of the 6 year old child.(staff # 3). It is not cleared how long the child was left unattended. According to staff # 1 this incident happened during the 10 minutes break of the staff # 3. Staff # 1 stated the absence of supervision must have occurred for couple of minutes. One child stated seeing 6 year od child got out of the classroom but could not tell for how long the child was gone. Child stated seeing the 6 year old came back with a witness. Three other children did not disclose any information. The incident happened around 4:45 pm. LPA attempted to contact the witness but no successful. LPA measured the Continued on page 2 SUPERVISORS NAME: Rina Lopez LICENSING EVALUATOR NAME: Mahnaz Malek LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY NAME: YMCA-HAWES PROGRAM CENTERFACILITY NUMBER: 300611774 VISIT DATE: 05/17/2022 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 26 27 28 29 30 31 32Page 2 of 2 distance from the classroom and the area the child was found. It was estimated 200 feet. Based on the information obtained through the staff # 1, staff # 2, and one child regarding the incident today, 6 year old child left the YMCA portable while the staff did not notice the child left. However the length of the time of absence of supervision is unknown. According to interviews the duration of absence might have happened couple of minutes. Section 101229(a)(1 Responsibility for Providing Care and Supervision Type A was cited on LIC 809D. An immediate civil penalty of 500.00 is hereby assessed for absence of supervision for today and 100.00 per day until corrected. Upon receipt of Type A violations, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility, and to the parents/guardians of children newly enrolled at the facility during the next 12 months. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. The Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Exit interview was conducted with director, Emily Perez. SUPERVISORS NAME: Rina Lopez LICENSING EVALUATOR NAME: Mahnaz Malek LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022 FACILITY NAME: YMCA-HAWES PROGRAM CENTER FACILITY NUMBER: 300611774 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 05/17/2022 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 05/18/2022 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1)..........................1 2 3 4 5 6 7The director agreed to send a statement signed b