380503900-4-19-2023-05-CC-JYEE-CR2N8S-20230419101450

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380503900
Report Date: 04/19/2023
Date Signed: 04/19/2023 10:14:55 AM

Document Has Been Signed on 04/19/2023 10:14 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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

FACILITY NAME:	YMCA OF SF., MISSION BRANCH, MISSION PRESCHOOL		FACILITY NUMBER:	380503900
ADMINISTRATOR:	ALVAREZ, KATIA		FACILITY TYPE:	850
ADDRESS:	4080 MISSION STREET		TELEPHONE:	(415) 586-6900
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94112
CAPACITY:	42	CENSUS: 20	DATE:	04/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Alexandra Hallum, Katia Alvarez		TIME COMPLETED:	10:30 AM

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) Yee conducted a Required - 1 Year inspection today. The purpose of the inspection was explained. Present at the facility are the site director, Alexandra Hallum, program director, Katia Alvarez, 4 staff members, and 20 children. Teacher-to-child ratios were met during today's visit. Days and hours of operation: Monday - Friday, 7:30 am - 6:00 pm. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and a carbon monoxide detector. The outside yard is adjacent to the classroom. LPA and site director toured and inspected the Center for Health and Safety Hazards. Daycare areas: classroom Butterfly, Koala, Monkey. The outside yard was inspected. There are no pools, spas, or other bodies of water on the premises. All cleaning supplies and other potentially harmful items are made inaccessible to the children. Furniture and equipment are in good condition. Isolation for a sick child is available in the site director office. The facility provides snacks, and lunches. Drinking water is provided indoors and outdoor. The last Emergency Drill was conducted on 4/5/23 and properly logged. During the inspection, LPA reviewed 4 staff’ members' files and was in order. At least one staff have current Pediatric First Aid and CPR on file (01/2025). Children's files were reviewed and in order. The facility has posted all the required licensing forms in a prominently visible location. LPA discussed Child Abuse Mandated Training AB1207 with the Site manager. 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. All staff members have current AB1207 certificates.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: YMCA OF SF., MISSION BRANCH, MISSION PRESCHOOL	FACILITY NUMBER: 380503900
	VISIT DATE: 04/19/2023

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
32

Pesticide regulations were discussed with the Site 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.

The site director was reminded that all adults 18 years and older working at the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, before initial presence in a licensed Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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. 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.

Lead water testing was done on 01/2023. PIN 21021-CCP and 22-06-CCP. A Lead water testing certificate is on file.

Annual fees is current.

An Exit Interview was conducted with Site director. No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2