380504384-1-8-2020-05-CC-AMEN-BKMRKF-20200108120527

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380504384
Report Date: 01/08/2020
Date Signed: 01/08/2020 12:05:32 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:	SFUSD-RAPHAEL WEILL (EES) PRESCHOOL		FACILITY NUMBER:	380504384
ADMINISTRATOR:	DARREN KAWAII		FACILITY TYPE:	850
ADDRESS:	1501 O'FARRELL STREET		TELEPHONE:	(415) 749-3548
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94115
CAPACITY:	60	CENSUS: 34	DATE:	01/08/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Agrinilda Waide		TIME COMPLETED:	12:20 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	Licensing Program Analyst (LPA) Andrea Medlin met with staff for this required annual licensing visit. There are 34 children present. Preschool program operates in classrooms #201 and #216 on the campus of SFUSD Rosa Parks Elementary School. Days and hours of operation: Monday-Friday 7:30AM-5:30PM. There are fire extinguishers, smoke detectors, and carbon monoxide (CO) detectors present. Physical plant toured, including the classrooms and outside area used for the program. There are age appropriate play structures cushioned with soft rubber. Outdoor activity space surfaces are free of hazards. Separate staff bathrooms are available. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per staff, there are no firearms or weapons on site. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Variety of age appropriate toys and materials for children are available. Facility provides cots for children to nap. Facility provides snacks and meals for children. Drinking water for children is available through water fountains. First aid supplies are available. Sick children will be separated from the group and wait for parents to pick up. Facility has posted all the required licensing forms in a central accessible location in the lobby. LPA reviewed staff and children's files. In the children’s files, all have immunizations and a copy of Parent's Rights. In the staff files reviewed, all have the required staff immunizations/immunity, staff have the required mandated child abuse reporting training, and verification of the appropriate educational requirements. Staff have current Pediatric First Aid and CPR certification. (Continued on next page 809-C)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

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

FACILITY NAME: SFUSD-RAPHAEL WEILL (EES) PRESCHOOL	FACILITY NUMBER: 380504384
	VISIT DATE: 01/08/2020

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

Incidental Medical Services (IMS) policy discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is 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 informed that effective 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 reviewed with director the Mandated Child Abuse Reporting training as compliant with AB 1207. As of January 1, 2018 all child care staff are required to complete Mandated Child Abuse Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

This report is reviewed with staff and a copy of this report must be made available for public review upon request.

Notice of site visit posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2