<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505307
Report Date: 07/22/2021
Date Signed: 07/22/2021 01:39:53 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-LEOLA HAVARD EARLY EDUCATION (SCHOOL AGE)FACILITY NUMBER:
380505307
ADMINISTRATOR:NWANKWO, NKECHIFACILITY TYPE:
840
ADDRESS:1520 OAKDALE AVENUETELEPHONE:
(415) 379-2700
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY:168CENSUS: 13DATE:
07/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Raul Erazo-ChavezTIME COMPLETED:
01:45 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 Analysts (LPAs), Farhan Bashir-Tariq and Sheran Lo arrived at the facility above unannounced and met with Executive Director, Raul Erazo-Chavez, to conduct a required one-year inspection. Purpose of inspection was explained. Present, there were 13 children in care with four teachers. Facility is operating within the capacity and is following staff child ratio on this day. Facility operates day care from Monday to Friday between 8:00 AM to 4:30 PM. Facility is part of food program and provides breakfast, lunch and two snacks. Prior to this on-site inspection, risk assessment was completed with clerical staff to identify any COVID risks. No risks were identified. Facility is currently running their summer program.

LPAs inspected the day care area with Director. There are no pools, spas or other bodies of water at the facility. LPA observed that facility has multiple fire extinguishers, smoke detectors and carbon monoxide detectors. First aid kit and emergency supplies were available for classrooms and outdoors. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility has sufficient amount of sleeping matts. Facility floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. Facility has drinking water available for children. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is soft cushioning available under the play structures to prevent any fall injuries. All Posting requirements were met. License, parent’s rights poster, emergency disaster plan and all other required licensing documents were observed to be posted in facility's at multiple locations Posters for COVID-19 symptoms, social distancing and other important information were observed to be posted. LPAs reviewed facility records. LPAs reviewed seven random children's and four random staff's files. LPAs observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's record contains the record immunization. Multiple staff members have record of valid CPR card in file. LPAs reviewed the educational qualification of all the teachers. Certificates of completion for mandatory child abuse training were observed in staff's file.
Page...1 of 2
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
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-LEOLA HAVARD EARLY EDUCATION (SCHOOL AGE)
FACILITY NUMBER: 380505307
VISIT DATE: 07/22/2021
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
During inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Facility was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Site Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov
*Site Director was reminded about the Provider Information Notices (PINs) on CCLD website.
*Site Director was reminded about of Mandated Reporter Training available on CCLD website.


>No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations. This report and rights to comment and appeal were discussed with Director. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from the date of visit. Facility was advised for any additional questions to call office, M-F, 8AM-5PM at 650-266-8800 . For Rules and Regulations, visit the Website: www.cdss.ca.gov
Page...2 of 2
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2