380506367-2-22-2023-05-CC-BVAN-CPARXM-20230222122500

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380506367
Report Date: 02/22/2023
Date Signed: 02/22/2023 12:25:06 PM

Document Has Been Signed on 02/22/2023 12:25 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SFUSD-THERESA S. MAHLER (EES) PRESCHOOL		FACILITY NUMBER:	380506367
ADMINISTRATOR:	COOK, CAROLYNE		FACILITY TYPE:	850
ADDRESS:	990 CHURCH STREET		TELEPHONE:	(415) 695-5871
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94114
CAPACITY:	80	CENSUS: 27	DATE:	02/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Carolyne Cook		TIME COMPLETED:	12:30 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 February 22, 2023, Licensing Program Analyst (LPA) Van conducted an unannounced annual mandated inspection and met with the new Director, Carolyne Cook. The purpose of the inspection was explained, and the Director granted LPA entry to the facility. This facility is a title 5 program operating in the SFUSD Theresa Mahler Early Education School site. All staff at the facility have caregiver background checks through the San Francisco Unified School District. The Director, four teachers, and six paraprofessionals supervised 27 children at the Center. The staff-to-children ratio was met. The Hours of operation are Monday to Friday, 7:30 am to 5:30 pm. LPA toured and inspected the physical plant with the Director for any potential health and safety hazards. The facility has a record of sign-in/out of children. All parents' signatures matched and accounted for the number of children present. LPA observed that each child has their cubbies available with their name labeled. The facility is in good repair and has proper temperature and ventilation. Classrooms have age-appropriate toys and learning materials. The furniture appears steady and in good repair. The facility has centralized carbon monoxide & smoke detectors, and multiple charged fire extinguishers, and working telephones. First aid supplies are fully stocked and available for children's use. All cleaning solutions, poisons, and other dangerous chemicals are inaccessible to children. Medications are stored and inaccessible to children, and all medications have proper labeling, unaltered, and parental consent. All toilets and handwashing sinks are in good working condition with proper sanitation. LPA observed no bodies of water on the premises. Continued on page 2...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFUSD-THERESA S. MAHLER (EES) PRESCHOOL	FACILITY NUMBER: 380506367
	VISIT DATE: 02/22/2023

NARRATIVE

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The outdoor play area is maintained clean and free of debris. The outdoor play area is completely fenced, clean, and in good repair. Outdoor play structures are in good condition and free of loose parts, and soft cushioning is underneath all play structures to absorb accidental falls.
Children's records and personnel records were reviewed during the inspection. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Staff records indicate that multiple staff members have a record of valid CPR and mandated reporter training. All staff maintained immunization records. The Director stated that the Center conducts fire and earthquakes monthly.
The facility had posted the required forms. (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Menus were observed and posted in each classroom. Waters are readily available for children indoors and outdoors. All storage containers for solid waste within the Center have a proper tight-fitting cover.
Incidental Medical Services (IMS) policy was discussed. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
The 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 the 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.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFUSD-THERESA S. MAHLER (EES) PRESCHOOL	FACILITY NUMBER: 380506367
	VISIT DATE: 02/22/2023

NARRATIVE

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The Director was informed about Mandated Reporter training. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare
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/process.
No deficiencies were cited today. An exit interview was conducted, and the report was reviewed with the Director, Carolyne Cook. Today's report and site visit notice were provided to the Director. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

LIC809 (FAS) - (06/04)

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