380500308-2-25-2022-05-CC-CQUO-CBYTSD-20220225135856

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380500308
Report Date: 02/25/2022
Date Signed: 02/25/2022 01:59:35 PM

Document Has Been Signed on 02/25/2022 01:59 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	HOLY FAMILY DAY HOME		FACILITY NUMBER:	380500308
ADMINISTRATOR:	POOYAN, SETAREH		FACILITY TYPE:	850
ADDRESS:	299 DOLORES STREET		TELEPHONE:	(415) 861-5361
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY:	150	CENSUS: 74	DATE:	02/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Setareh Pooyan & Heather Morado		TIME COMPLETED:	02:15 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	On February 25, 2022 at 9:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual, required inspection to Holy Family Day Home. LPA met with facility director, Setareh Pooyan, and executive director, Heather Morado. Facility is a combination center of a preschool and infant program. Hours of operation are Monday to Friday 7:30am to 5:30pm. Under preschool license, there are 74 preschoolers and 13 staff members at time of inspection. Facility is operating within teacher to child ratio on this date. With facility and executive director, LPA inspected facility for health and safety hazards. Preschool classrooms are separated into 4 classrooms for 4 separate age groups. Each classroom includes eating, quiet, and dramatic play areas. Classrooms have sufficient temperature and ventilation. Storage for children's belongings are located inside each classroom, labeled with each child's individual names. LPA observed facility has multiple carbon monoxide detectors, multiple fire extinguishers and a fire alarm system installed in the entire building. Facility has a working telephone on site. LPA observed poisoning, cleaning solutions and hazardous materials are stored inaccessible to children. Facility has age appropriate furniture and materials for each classroom. There were a variety of age appropriate toys for children in care. Cots and sheets are provided to napping children, that are sanitized daily. Each classroom has a bathroom that were observed to be clean and in working condition. Hand washing stations for children do not provide water that is more than 120 degrees Fahrenheit. Facility provides food service. LPA inspected kitchen and food prep areas, which were observed to be clean, neat and orderly. LPA did not observe poisonous materials to be near food preparation areas. All food is stored and prepared properly to avoid contamination. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HOLY FAMILY DAY HOME	FACILITY NUMBER: 380500308
	VISIT DATE: 02/25/2022

NARRATIVE

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Preschool program shares outdoor space with infant license. Directors are aware preschool and infant children are not to use shared outdoor playgrounds at the same time. LPA observed outdoor space to have separated areas for each program. Outdoor area does not consist of any pools, spas or bodies of water. There is a chicken coop in outdoor area that is kept separate from children's play areas. LPA observed chicken coop to be properly maintained and cleaned. Water is made available to children indoors and outdoors with facility's water pitcher and/or children's individually labeled water bottles.

Children are signed in and out of facility by parents' electronic signatures. Facility has license documentation and information properly posted and available for review.

LPA reviewed facility records that included 10 children's records and 13 staff files (whom were present during inspection). Children's and staff's records were observed to be complete. Multiple staff members on site have valid CPR certificates. Facility director's CPR and First Aid certificate is current and will expire March 2022. Last emergency drill conducted January 21, 2022. Emergency drills are conducted monthyl and are properly logged and documented.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Directors are aware that all staff are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completed certificates on file. LPA encourages directors to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. 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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SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HOLY FAMILY DAY HOME	FACILITY NUMBER: 380500308
	VISIT DATE: 02/25/2022

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LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information
regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies were issued under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility director, Setareh Pooyan, and executive director, Heather Morado.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

LIC809 (FAS) - (06/04)

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