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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504942
Report Date: 03/22/2022
Date Signed: 03/22/2022 05:07:58 PM

Document Has Been Signed on 03/22/2022 05:07 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:ASSOCIATED STUDENTS CHILDREN'S CENTER - PRESCHOOLFACILITY NUMBER:
380504942
ADMINISTRATOR:ALMAGUER, ERICAFACILITY TYPE:
850
ADDRESS:1650 HOLLOWAY AVENUETELEPHONE:
(415) 338-2403
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94132
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 0DATE:
03/22/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Erica AlmaguerTIME COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Marie Rodriguez conducted an unannounced case management inspection to follow up on an incident that was reported to CCLD office on March 14, 2022. LPA met with Director Erica Almaguer and explained purpose of inspection. Present at the school were the Director and three staff members. Center is currently closed for Spring Break this week so there were no children in care.

The incident reported occurred when a child was playing with a toy rocket out on the playground and it flew into the garden. Although there was an entrance to the garden, the child decided to climb over the low wall next to the entrance quickly to retrieve the rocket and fell hitting her chin on the wooden step. LPA inspected the playground and garden area and interviewed staff who witnessed the incident. There was sufficient staffing at time of incident.

No deficiencies cited today under California Code of Regulations, Title 22, Division 12.

Report was reviewed and discussed with Director Erica Almaguer. A copy of report was provided.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2022
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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