380506430-12-10-2021-05-CC-CQUO-C9KR6D-20211210114436

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380506430
Report Date: 12/10/2021
Date Signed: 12/10/2021 11:45:10 AM

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 PRESC		FACILITY NUMBER:	380506430
ADMINISTRATOR:	BALUYUT, MA CONCEPCION		FACILITY TYPE:	850
ADDRESS:	221 VALLEY STREET, ROOM X		TELEPHONE:	(415) 824-5437
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	38	CENSUS: 0	DATE:	12/10/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Director, Concepcion Baluyut		TIME COMPLETED:	11:30 AM

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 December 10, 2021 at 9:00am, Licensing Program Analyst (LPA) Catrina Quimbo, met with facility director, Ma Concepcion "Tina" Baluyut, for a case management inspection. Facility temporarily ceased operations due to construction and flooding of facility. Program operations temporarily relocated to Fac #384001548. Director requested to resume program operations back to Fac #380506430. Present during inspection was director. All staff members currently working in facility have cleared criminal background clearances and are associated to facility. Hours of operations are Monday to Friday 8:00am to 5:00pm. LPA and director inspected day care areas for health and safety hazards. At approximately 9:15am, LPA observed day care areas to be in good repair. LPA observed space to be small for licensed capacity of 38 children. LPA remeasured day care areas to be used and calculated for a total of 1,045.96 sq. ft equaling a total capacity of 29 children. Facility has sufficient temperature and ventilation. Facility is equipped with a variety of age appropriate toys and materials that are in good condition. All electrical outlets accessible to children have child safety covers. LPA observed multiple smoke detectors, carbon monoxide detectors, fully charged fire extinguishers and fully stocked first aid kits. Children’s bathrooms, toilets and sinks are clean and sanitary. There are 3 toilets and 4 sinks accessible to enrolled children. Total allowable capacity for toilets is 45 children. Total allowable capacity for sinks is 60 children. Garbage cans have tight fitting lids. All cleaning supplies and poisons are made inaccessible to children in care. (Continued Report on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021

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: ST. PAUL'S CHURCH-LITTLEST ANGEL PREPARATORY PRESC	FACILITY NUMBER: 380506430
	VISIT DATE: 12/10/2021

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

(Continued, Page 2...)

LPA observed outdoor play area to be in good condition, equipped with age appropriate materials. LPA remeasured outdoor play area, total allowable capacity was calculated for equaling 633.158 sq. ft allowing for a capacity of 8 children. Outdoor area has sufficient shade and resilient padding. Water is made available to children both indoors and outdoors.

No deficiencies were observed today. Operations at Facility #380506430 have been approved to resume, under conditions of this report with waiver approvals.

After today’s inspection, an exit interview was conducted with director, Tina Baluyut. A copy of this report along with Appeal Rights and Notice of Site Visit were provided to director at tina@littlestangelpreschool.com. LPA advised director to acknowledge report was received.
Director 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: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2