380505534-1-15-2020-05-CC-LGOZ-BKV3ER-20200115171136

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380505534
Report Date: 01/15/2020
Date Signed: 01/15/2020 05:11:50 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:	FAMILY DEVELOPMENTAL CENTER (INFANT)		FACILITY NUMBER:	380505534
ADMINISTRATOR:	QUIROZ, YOHANA		FACILITY TYPE:	830
ADDRESS:	2730 BRYANT STREET		TELEPHONE:	(415) 282-1090
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	95	CENSUS: 49	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Alicia Torres, Yohana Quiros		TIME COMPLETED:	05:25 PM

NARRATIVE

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Licensing Program Analyst, Luis J. Gomez met with Education Director, Alicia Torres, Chief Operations Officer, Yohana Quiros. Purpose of the inspection was explained and is for an unannounced annual inspection. This is a combination center, with a preschool program on site. Classrooms under the Infant program have a toddler option. Facility operates under title five regulation. Infant/ Toddler program utilizes six classrooms: Rainbow (0 to 1.5 year old), Little bear (1.5- three year old), Star (1.5- three year old), Ladybugs (0- 1.5 year old), Caterpillar ( 0- 1.5 year old), Butterfly (1.5- three year old) and an outdoor infant play area. Hours of operation are Monday- Friday 7:30am- 4:30pm. Infant program operates year around. Present is the Chief Operations Officer, Education Director and 17 staff supervising 49 children. Facility is operating within capacity limits of the license on this day. LPA Gomez inspected facility for health and safety hazards.

At 2:20pm on January 15, 2020 LPA inspected the following classrooms: Rainbow: Room 105, Little bears: Room 107, Star: Room 119, Ladybugs: Room 122, Caterpillar: Room 124, Butterfly: Room 132. Classrooms are organized and have plenty of age appropriate toys for the children. Each classroom has cubbies, several child size tables and chairs for snack and activities. Rainbow, Little bear, Stars, Caterpillar have diaper changing tables. Diaper changing tables, located in the infant classroom, are within reach of a sink. Classrooms are equipped with a refrigerator and cabinets for storage. The staff restrooms are in the hallway. All bottle and milk were inspected and is properly stored and labeled. Each child has their own assigned cribs/ cots available in the classrooms. Children's blankets are washed at the facility and are taken home by the families to be washed weekly. All heater vents are properly covered. At 3:45pm on January 15, 2020 LPA observed office supplies and materials, in the napping area of the Caterpillar classroom, accessible to the day-care children. All detergents, cleaning supplies and toxins are made inaccessible, stored in an off-limits area. Children’s bathrooms, located in the classrooms, are maintained clean with adequate supplies. Stepping stools are available for increased accessibility. There is acceptable ventilation and natural lighting. Each classroom has a smoke detector, carbon monoxide detector and a fully charged fire extinguishers (2A:60BC) located in the facility hallway. First aid kits and emergency disaster supplies are available in each classroom, by the front door.

(Continuation on 809-C)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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 4

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: FAMILY DEVELOPMENTAL CENTER (INFANT)	FACILITY NUMBER: 380505534
	VISIT DATE: 01/15/2020

NARRATIVE

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(Page 2)
At 3:50pm on January 15, 2020 LPA inspected the Infant Outdoor Play yard. LPA observed infant outdoor play yard is completely enclosed. Yard has a children’s play structure that is properly anchored and rubber padding for increase safety. Outdoor play courtyard is kept clean and free of debris and hazardous items. All outdoor equipment is in good repair.

Six children records were reviewed. All children files reviewed are complete. Staff CPR/ 1^st aid certification is current expiring: 10/2021. Emergency drills are conducted at the facility, with the last drill done on: 12/18/2019, properly logged. LPA Gomez observed required licensing information and outdoor space waiver properly posted in facility lobby. Program serves all daily snack and meals for children in care.

Incidental Medical Services (IMS) was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding Americans with Disabilities Act (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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: www.ada.gov/childqanda.htm.

During inspection,

· Director was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.662.
· Director was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com
· Director was reminded about the Provider Information Notices (PINs) on CCLD website.
Licensee was advised for any additional questions to contact CCLD office, Monday to Friday, 8:00 am - 5:00 pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov

(Continuation page 3)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: FAMILY DEVELOPMENTAL CENTER (INFANT)	FACILITY NUMBER: 380505534
	VISIT DATE: 01/15/2020

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Page 3...
Based on today's inspection, a deficiency was observed in the areas evaluated according to the Title 22 Division 12 Ca. Code of Regulations and cited on the 809-D page. Director and LPA discussed a plan of correction and an exit interview was conducted with Yohana Quiros, and her signature of this form acknowledges receipt of these documents.

>This report and rights to comment and appeal were discussed with Yohana Quiros. This report must be available in the facility for public review. Notice of site inspection was posted.
Yohana Quiros was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: FAMILY DEVELOPMENTAL CENTER (INFANT)	FACILITY NUMBER: 380505534
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/15/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/22/2020 Section Cited	1 2 3 4 5 6 7	101238(a) Building and Ground. The child care center shall be clean, safe and sanitary and in good repair at all times. The requirement is not met as evidenced by.
	8 9 10 11 12 13 14	Based on observations, LPA observed office supplies and materials, in the napping area of the Caterpillar classroom, accessible to the day-care children. This is a potential health and safety risk children in care.	8 9 10 11 12 13 14	Director will submit proof of correction to LPA Gomez via email
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 4 of 4