380504742-1-8-2020-05-CC-AMEN-BKN2B3-20200108161429

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380504742
Report Date: 01/08/2020
Date Signed: 01/08/2020 04:14:36 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:	CCFC-EDDY		FACILITY NUMBER:	380504742
ADMINISTRATOR:	DAVIDSON, FONDA		FACILITY TYPE:	850
ADDRESS:	1672 EDDY STREET		TELEPHONE:	(415) 567-9126
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94115
CAPACITY:	50	CENSUS: 12	DATE:	01/08/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Gayathri Kekulawela		TIME COMPLETED:	04:20 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 annual licensing visit. Purpose of visit explained. There are 12 children present during the visit. Facility meets teacher/child ratio today. Days and hours of operation: Monday-Friday 7:30AM-5:30PM. The facility has a fully charged fire extinguisher that meet the minimum requirements, smoke detectors, and a carbon monoxide (CO) detector in facility. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per director, 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 is available. Classrooms are set up for child care and furniture and equipment for children is present. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. Facility provides snacks and meals; sample menu is posted. Children use provided cots to nap; facility provides all napping supplies. Outdoor play area inspected for health and safety hazards. The areas outside are cushioned with soft rubber. Outdoor activity space is fully fenced and surfaces are free of hazards. Facility has posted all the required licensing forms in prominent accessible locations. 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 or proof of immunity and verification of meeting the educational requirements. Staff do not have the required mandated child abuse reporting training as compliant with AB1207. At least one staff has current Pediatric First Aid and CPR certification. Last emergency drill was conducted in 11/2019 and is appropriately logged. (Continued on next pages 809-C and 809-D)

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)

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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: CCFC-EDDY	FACILITY NUMBER: 380504742
	VISIT DATE: 01/08/2020

NARRATIVE

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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.

The deficiencies cited on the following page are in violation of the California Code of Regulations, Title 22, Division 12, Chapter 1:

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 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: CCFC-EDDY	FACILITY NUMBER: 380504742
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/08/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/10/2020 Section Cited	1 2 3 4 5 6 7	On and after January 1, 2018, a person who becomes an administrator or employee of a licensed child day care facility shall complete the mandated reporter training within the first 90 days of employment.
	8 9 10 11 12 13 14	This requirement is not met as evidence staff do not have the mandated child abuse reporting training compliant with AB 1207. This is a potential health and safety risk.	8 9 10 11 12 13 14	For access to the training: www.mandatedreporter.ca.com Proof of correction shall be sent to the licensing office by 2/10/2020.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

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 appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

LIC809 (FAS) - (06/04)

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