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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380506509
Report Date: 12/13/2019
Date Signed: 12/13/2019 11:51:14 AM

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 CTR-COMPASS FAM SRVS INFANTFACILITY NUMBER:
380506509
ADMINISTRATOR:PERLA, ELIZABETHFACILITY TYPE:
830
ADDRESS:111 PAGE STREETTELEPHONE:
(415) 863-0681
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY:8CENSUS: 1DATE:
12/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Elizabeth PerlaTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Kaur met with director, Elizabeth Perla , for a random annual inspection. Purpose of the inspection was explained. Present, there is 1 infant with 1 teacher, and the director. Facility is operating within the capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday between 07:30 AM to 5:30 PM,

With director, LPA inspected the day care classrooms and play yard. There are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, carbon monoxide detectors and fully charged fire extinguishers on site. Facility has working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored in high cabinets and are inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. All toilets, hand washing facilities are in working condition with proper sanitation in place. Facility has drinking water available for children. Facility has first aid supplies available at the multiple locations. All of the unused electrical outlets have child protective covers installed. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. The outdoor area has several large plastic play structures and the structures were observed to be in good condition. There is sufficient amount of shaded area available for children to use. The school provides 2 snacks and a lunch to the older toddlers, the food is prepared off site by Chefables and brought in on a daily basis. If the infant requires formula the parents will provided it, breast milk will be labeled and refrigerated.


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SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
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 CTR-COMPASS FAM SRVS INFANT
FACILITY NUMBER: 380506509
VISIT DATE: 12/13/2019
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At 11 AM, LPA reviewed the facility records. LPA observed that facility has sign in / out record with full legal signatures. Facility has all of the required documents posted and visible for the public. LPA reviewed 4 random infant and 1 staff file. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Facility has record of immunization of each child attending child care. LPA observed facility has record of staff’s immunization on file. LPA reviewed the educational qualification of all the teachers. CPR class registration was provided.

LPA review AB 1207 with the director. Director is aware that 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.

Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPA discussed the effects of lead exposure with the director and a handout was provided. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
LIC809 (FAS) - (06/04)
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