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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380506430
Report Date: 09/20/2019
Date Signed: 09/20/2019 01:02:21 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:ST. PAUL'S CHURCH-LITTLEST ANGEL PREPARATORY PRESCFACILITY NUMBER:
380506430
ADMINISTRATOR:LAZZARINI, MARGARETFACILITY TYPE:
850
ADDRESS:221 VALLEY STREET, ROOM XTELEPHONE:
(415) 824-5437
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94131
CAPACITY:38CENSUS: 0DATE:
09/20/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Director, Margaret LazzariniTIME COMPLETED:
01:20 PM
NARRATIVE
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Licensing Program Analyst (LPA), Luis J. Gomez met with Director Maraget Lazzarini for this plan of correction visit established on July 12, 2019. Present today is the director and 6 staff. Facility is closed for a staff meeting today. LPA Gomez toured the facility for health and safety hazards. The following deficiency from the previously inspection was checked today:

1596.8662 Availability of Information. LPA Gomez observed facility personnel have not completed the mandated reporter training.


Director, Margaret Lazzarini provided LPA proof of correction. Deficiency issued on
July 12, 2019 have been cleared. 'Cleared POC Letter' was given to Licensee.

**No deficiencies were cited against the facility today under CCR,Title 22, Div. 12, Chapt. 1**

>This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit was observed being posted.
Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019
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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