380503897-3-4-2020-05-CC-WLYY-BME3QC-20200304172655

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380503897
Report Date: 03/04/2020
Date Signed: 03/04/2020 05:27:00 PM

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:	CORNERSTONE ACADEMY		FACILITY NUMBER:	380503897
ADMINISTRATOR:	LEI, CARRIE		FACILITY TYPE:	850
ADDRESS:	1943 LAWTON STREET		TELEPHONE:	(415) 661-8810
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94122
CAPACITY:	60	CENSUS: 42	DATE:	03/04/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:50 PM
MET WITH:	Carrie Lei		TIME COMPLETED:	05:30 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 March 04, 2020, at approximately 3:50pm, Licensing Program Analyst (LPA) Winnie Ly conducted an Unannounced Required - 1 Year Visit and met with Site Director, Carrie Lei during the visit. Purpose of the inspection was explained. There are 42 children 4 staff members. Teacher to child ratios were met on this day. Per Director, the license facility The facility occupies 3 addresses consisted of 3 classrooms. Currently, one classroom bearing the address number 1943 is vacant meaning no one is enrolled in that classroom. The facility has no outdoor area and they do have a waiver that enables them to use the "Sunset Playground" which is about 2 blocks away. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and a carbon monoxide detector. The facility operates Monday - Friday from 7:00 AM to 6:00 PM. The center uses a clip board for parents to sign their children in/out. All children were signed in today. Facility has posted all the required licensing forms in a prominent visible location. LPA and Site Director inspected the center for Health and Safety Hazards. There are no pools, spas or other bodies of water on the premises. Per the Site Director, there are no firearms or weapons in the center. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. All cleaning supplies and other potentially harmful items are stored inaccessible to the children. Medications are stored in locked cabinet inaccessible to children. LPA reviewed medication procedures with staff. Furniture and equipment are in good condition, free from loose, sharp or pointed parts. Children's bathrooms are in working order with adequate supplies. There are separate bathroom on site for adults. The food preparation area is clean and orderly. The center provides morning snack, lunch and afternoon snack. Center prepares food on site. Menus are posted in the center. All solid waste storage containers have tight fitting lids. Drinking water is provided indoor with water pitcher and disposable cups. Last Emergency Drill was conducted on 02/21/2020 and properly logged. CONTINUED>>>

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie Ly	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

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: CORNERSTONE ACADEMY	FACILITY NUMBER: 380503897
	VISIT DATE: 03/04/2020

NARRATIVE

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Facility has an Incidental Medical Services (IMS) on file. Per Director, currently no one in care is utilizing the IMS plan. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Facility was also 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.

LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the Director. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one hour online course is available on the Department of Pesticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

Director was also advised to reach out to San Bruno Regional Office for concern or questions. Desk Duty is available M-F, 8a.m.-5p.m. (650) 266-8800. Website for forms and regulations updates: www.cdss.cs.gov/inforesources/Community-Care-Licensing

An Exit Consultation was conducted with Site Director. No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. A copy of this report and appeal rights were discussed and left with Director whose signature on this form confirm receipt of these reports. Notice of Site Visit was posted. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie Ly	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

LIC809 (FAS) - (06/04)

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