MISSION VALLEY YMCA - LONGFELLOW ELEMENTARY SCHOOL

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 25On 11/15/21 @ 1:20PM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced inspection in reference to a self-reported unusual incident that involved an 8-year old school-age child who was left unsupervised by staff for approximately 5 minutes. Teacher in charge left behind a child unattended in the bathroom. LPA met with Alex Bell, Site Director. Observed present today were 46 school-age children with staff Stephanie Mondragon; Davion Dewberry; Regan Salas; Destinee Martinez & Saray Martinez. Type A deficiency was cited. Type A deficiency if not corrected poses an immediate risk to the health, safety or personal rights of children in care. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Exit interview was conducted with Mr. Bell. Appeal rights were discussed. A written copy of the appeal rights and Licensing report was provided to Mr. Bell today. A notice of site visit was provided today and was observed posted by Mr. Bell. Continued... SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Nancy Diaz 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)Page: 1 of 2 FACILITY NAME: MISSION VALLEY YMCA - LONGFELLOW ELEMENTARY SCHOOL FACILITY NUMBER: 376600371 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/15/2021 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 11/15/2021 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION. No child(ren) shall be left without the supervision of a teacher at any time... This requirement was not met as evidenced by:1 2 3 4 5 6 7DEFICIENCY CORRECTED. Site Supervisor Alex Bell met with all his staff to discuss the importance of providing visual supervision at all times. Rosters were provided to all staff. Staff are to conduct name to face counts, headcounts and name counts when transitioning to another area. A copy of site meeting agenda conducted on 1/1/21 was provided by Mr. Bell today. 8 9 10 11 12 13 14Based on documents received from the facility director and interview conducted with the child involved, it was reported that a child was left unattended and without supervision by a staff in the bathroom on 10/28/21. Facility speculated that the child was left unattended for approximately 5 minutes. 8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Tashima Daniel LICENSING EVALUATOR NAME:Nancy Diaz 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

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 11/15/21 @ 1:20PM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced inspection in reference to a self-reported unusual incident that involved an 8-year old school-age child who was left unsupervised by staff for approximately 5 minutes. Teacher in charge left behind a child unattended in the bathroom. LPA met with Alex Bell, Site Director. Observed present today were 46 school-age children with staff Stephanie Mondragon; Davion Dewberry; Regan Salas; Destinee Martinez & Saray Martinez. Type A deficiency was cited. Type A deficiency if not corrected poses an immediate risk to the health, safety or personal rights of children in care. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Exit interview was conducted with Mr. Bell. Appeal rights were discussed. A written copy of the appeal rights and Licensing report was provided to Mr. Bell today. A notice of site visit was provided today and was observed posted by Mr. Bell. Continued... SUPERVISORS NAME: Tashima Daniel LICENSING EVALUATOR NAME: Nancy Diaz 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)Page: 1 of 2 FACILITY NAME: MISSION VALLEY YMCA - LONGFELLOW ELEMENTARY SCHOOL FACILITY NUMBER: 376600371 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/15/2021 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 11/15/2021 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION. No child(ren) shall be left without the supervision of a teacher at any time... This requirement was not met as evidenced by:1 2 3 4 5 6 7DEFICIENCY CORRECTED. Site Supervisor Alex Bell met with all his staff to discuss the importance of providing visual supervision at all times. Rosters were provided to all staff. Staff are to conduct name to face counts, headcounts and name counts when transitioning to another area. A copy of site meeting agenda conducted on 1/1/21 was provided by Mr. Bell today. 8 9 10 11 12 13 14Based on documents received from the facility director and interview conducted with the child involved, it was reported that a child was left unattended and without supervision by a staff in the bathroom on 10/28/21. Facility speculated that the child was left unattended for approximately 5 minutes. 8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Tashima Daniel LICENSING EVALUATOR NAME:Nancy Diaz 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