380504535-2-25-2022-05-CC-BVAN-CBYSWG-20220225131419

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380504535
Report Date: 02/25/2022
Date Signed: 02/25/2022 01:15:31 PM

Document Has Been Signed on 02/25/2022 01:15 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:	LITTLE STAR		FACILITY NUMBER:	380504535
ADMINISTRATOR:	CAMACHO, CHLORIS		FACILITY TYPE:	850
ADDRESS:	2540 TARAVAL STREET		TELEPHONE:	(415) 753-3442
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	45	CENSUS: 21	DATE:	02/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Chloris Camacho		TIME COMPLETED:	01:15 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, Licensing Program Analysts (LPAs) Van and Leong met with the new Director, Chloris Camacho, for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the Director. There are three teachers and a Director supervising 21 children. This facility is a preschool program and operates at the ground level on the right side of the Grace United Methodist Church. Days and hours operations are Monday - Friday 8:00 am-5:00 pm. The isolation area for an ill child is in the cots storage area, and the staff will monitor and supervise the child while parents are contacted to come and pick up the child. LPAs inspected the facility for health and safety hazards. The facility operates on a large open floor divided into three groups/cohorts. Each cohort has a teacher supervising from 8 to 12 children. The facility uses storage shelves to separate the different cohorts. All cohorts have age-appropriate toys and learning materials. Furniture appears steady and in good repair. The facility has multiple carbon monoxide detectors, a centralized smoke alarm, fully charged fire extinguishers, and working telephones. LPAs observed that each child has their cubbies available with their name labeled. All emergency supplies are stored in locked storage. Medications are appropriately labeled and stored out of reach of children. First aid supplies are available. The facility has two children's bathrooms with a total of 3 toilets, 1 urinal, and 3 sinks. There is also a water fountain. However, due to COVID, the water fountain was turned off, and children brought their own bottles from home. Children's toilets and sinks are in good working condition with proper sanitation. The staff has a separate bathroom inside the church. All cleaning solutions, poisons, and other dangerous chemicals have been stored in an area inaccessible to children. Outdoor play structures are age-appropriate and in good condition. There are wood chips underneath all play structures to absorb accidental falls, and the sands area is well maintained. LPAs observed no bodies of water on the premises.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	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: LITTLE STAR	FACILITY NUMBER: 380504535
	VISIT DATE: 02/25/2022

NARRATIVE

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LPAs observed that the facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Fire and Earthquake drills are done about every month and are appropriately logged. The facility provides breakfast, lunch, and snacks to children. A menu is reviewed and is posted today. The food preparation area is adequately equipped, clean, and free of hazards; this area is made inaccessible to children in care. All storage containers for solid waste within the Center have a proper tight-fitting cover.

Ten random children's records and all personnel records were reviewed during the inspection. LPA observed that the facility has a sign-in/out log with parents' signatures. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record can be located in each child's file. Staff records review showed multiple staff members have current Mandated Reporter Training, valid CPR in the file, and immunization on their respective file. LPA reviewed the educational qualification of all the teachers, and all teachers had the required ECE units. During the inspection, LPA obtained the Incident Medical Services (IMS) plan from the Director.

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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to initial presence in a 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.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	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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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: LITTLE STAR	FACILITY NUMBER: 380504535
	VISIT DATE: 02/25/2022

NARRATIVE

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The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to complete every two years by the Licensee/Director and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPAs encouraged the Director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the 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/process.

No deficiencies are cited today. An exit interview was conducted, and the report was reviewed with the Director, Chloris Camacho. Today's report, February 25, 2022, and notice of site visit will be sent to the Director by email by the close of business on February 25, 2022. Confirmation of receipt is required. LPAs informed the Director that the notice of site visit must be posted for 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	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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