380506508-7-9-2019-05-CC-BVAN-BDWW3M-20190709165611

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380506508
Report Date: 07/09/2019
Date Signed: 07/09/2019 04:56:17 PM

COMPREHENSIVE INSPECTION

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:	HELEN HAWK CHILDREN'S CENTER - PRESCHOOL		FACILITY NUMBER:	380506508
ADMINISTRATOR:	PERLA, ELIZABETH		FACILITY TYPE:	850
ADDRESS:	111 PAGE STREET		TELEPHONE:	(415) 863-0681
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94102
CAPACITY:	9	CENSUS: 4	DATE:	07/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Elizabeth Perla		TIME COMPLETED:	05:00 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	Licensing Program Analysts (LPA) Van met with Childcare Coordinator, Elizabeth Perla for a random annual inspection. Purpose of the inspection was explained. Facility is a preschool program center. Present, there are 4 children with 1 staff. Days and hours of operations are from Monday to Friday between 7:30 Am to 5:30 PM. With coordinator, LPA inspected the day care areas. Variety of age appropriate toys and learning materials for children are available. Classroom is set up for child care; furniture, equipment, sufficient amount of sleeping mats for children are available. All children's chairs and table have rounded corner. There are no pools, spas or other bodies of water at the facility. Facility has smoke detector, carbon monoxide detector, fully charged fire extinguisher and a working telephone. All cleaning solutions, poisons and other chemicals that are dangerous stored inaccessible to children. Sick children will be separated from the group and will be waiting in coordinator's office for parents to pick up. LPA observed the unused electrical outlets have covers installed. The facility is in good repair and free of any hazards with proper temperature and ventilation. All the bathrooms, toilets and sinks are clean and well sanitized. All solid waste bins have proper tight fitted lid on top. Facility has drinking water bottle with each child's name labeled. Per coordinator, facility provides meals to the children. Outdoor playground area is in good repair, play structures are securely anchored, free of any loose parts and has sufficient amounts of pads under the play structures to prevent any fall injuries. LPA reviewed the staff’s and children’s records. LPA observed that facility has an electronic sign in / out record with full legal signatures from parent or authorized representative. Staff member has record of valid CPR card in file. There are menus posted at least one week in advance and are visible to the child's authorized representative. LPA also observed facility has posted the required forms (i.e. License, menus, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). Coordinator states Fire and Earthquake drills are done each month, the last fire drill was logged on 4/17/19 . Discipline is talking to the children. continue on the next page........................

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2019

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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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: HELEN HAWK CHILDREN'S CENTER - PRESCHOOL	FACILITY NUMBER: 380506508
	VISIT DATE: 07/09/2019

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Continuation from the previous page......................

LPA reminded the coordinator 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. LPA observed the facility has record of required immunization of staff.

LPA reviewed AB 1207 with the coordinator. As of January 1, 2018, 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 training completion certificates of staff in the files.

No deficiencies are cited today. The copy of this report is reviewed and provided to the Elizabeth Perla. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2019

LIC809 (FAS) - (06/04)

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