380505725-10-24-2022-05-CC-CQUO-CKHTCT-20221024143715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380505725
Report Date: 10/24/2022
Date Signed: 10/24/2022 02:37:49 PM

Document Has Been Signed on 10/24/2022 02:37 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:	ST. NICHOLAS DAY CARE AND PRESCHOOL-INFANT		FACILITY NUMBER:	380505725
ADMINISTRATOR:	TUWAI, KATHY		FACILITY TYPE:	830
ADDRESS:	5200 DIAMOND HEIGHTS BLVD.		TELEPHONE:	(415) 550-1536
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	39	CENSUS: 22	DATE:	10/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Kathy Tuwai		TIME COMPLETED:	02:45 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	On October 24, 2022 at approximately 8:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with director, Kathy Tuwai, and explained the purpose of the inspection. Facility operates on lower level of St. Nicholas Orthodox Church. Hours of operation are Monday to Friday 7:45am to 5:30pm. Facility is a combination center of a preschool and infant program. Under infant license, there is one classroom: Caterpillars. Under infant license, present during LPA's visit included 8 staff members (including director) with 22 enrolled infants. Facility is operating within capacity limits and ratio during LPA's visit. With director, LPA inspected the entire facility for health and safety hazards. Infant classroom was observed to be clean, with proper temperature and ventilation. Infant classroom includes two separate napping areas for infants. One area for infants who sleep in cots and a separate area for infants who sleep in cribs. Both napping areas were observed to have age appropriate furniture and equipment that were in good condition. Per director, cribs and cots are cleaned daily. Infant classroom also includes areas for infants to eat, play and have "tummy time". Storage for infants' belongings are located inside the classroom, labeled with each child's individual names. Classroom and napping area are equipped with working, carbon monoxide detectors and fully charged fire extinguishers. Diaper changing tables are located in infant classroom and are within arm's reach to an adult sink. Infant classroom also includes a kitchen that is made inaccessible to infants with a child safety gate. Director stated kitchen area is maintained for staff to prepare infants' meals. Water is made available through filtered water stations. LPA observed kitchen to be clean and orderly. Food is stored and prepared appropriately to avoid any contamination. LPA observed infants' bottles and foods to be properly stored and labeled with each infants' name. (Continued, Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

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: ST. NICHOLAS DAY CARE AND PRESCHOOL-INFANT	FACILITY NUMBER: 380505725
	VISIT DATE: 10/24/2022

NARRATIVE

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LPA observed all poisons, cleaning supplies, and hazardous materials to be stored inaccessible to children, located in classroom's off limit area or stored in facility's high shelves.

Infant classroom has age appropriate furniture and materials for infants that are crawling, balancing and learning to walk. LPA observed toys and materials to be age appropriate and in working condition.

Infant program shares "outdoor area"/atrium with preschool program on a rotation schedule. Director is aware infant and preschool children are not to use atrium at the same time. LPA observed atrium to have sufficient toys and materials that were in good working condition. Area includes a climbing structure that was observed to have resilient padding underneath. Poles located in atrium are appropriately padded. LPA observed drain located in atrium to be properly covered and made inaccessible to children.

Facility has license documentation and information properly posted and available for review. Emergency drills are conducted at least once every six months and are properly logged and documented. Last emergency disaster drill was conducted 07/13/2022. Facility also maintains sleeping logs for napping infants. Logs include the time infants are sleeping, time they are being checked on and initials of staff member physically checking on sleeping infant.

LPA reviewed facility records that included 5 children's records and 5 staff records. LPA observed children's records to be complete and properly maintained. There was a record of emergency identification information on file for each enrolled infant. Infants and Services Needs Plan for each infant was made available for review. Multiple staff members in classroom have a CPR/First Aid certification that is current. Director's CPR/First Aid is current and will expire 01/2022.

Director was informed that as of 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.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.
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SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

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: ST. NICHOLAS DAY CARE AND PRESCHOOL-INFANT	FACILITY NUMBER: 380505725
	VISIT DATE: 10/24/2022

NARRATIVE

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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/inspection-process.

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.

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. Program is providing IMS at this time. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies were cited today under CCR, Title 22, Div. 12.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements will result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with director, Kathy Tuwai.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

LIC809 (FAS) - (06/04)

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