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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000047
Report Date: 06/28/2022
Date Signed: 06/28/2022 03:27:20 PM

Document Has Been Signed on 06/28/2022 03:27 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SFUSD-PRESIDIO EARLY EDUCATION SCHOOL (PS)FACILITY NUMBER:
384000047
ADMINISTRATOR:COOK, CAROLYNEFACILITY TYPE:
850
ADDRESS:387 MORAGA AVETELEPHONE:
(415) 561-5822
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94129
CAPACITY: 109TOTAL ENROLLED CHILDREN: 30CENSUS: 23DATE:
06/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Carolyne CookTIME COMPLETED:
03:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mok conducted an unannounced case management inspection for an unusual incident the facility reported to CCL on 5/17/22. LPA met with the Site Director, Carolyne Cook. The purpose of the inspection was explained to her. There were 23 children with 4 staff present. The incident related to a child told his/her parents that a staff slapped his/her face on 5/9/22. LPA interviewed staff and obtained relevant documents from the facility during the inspection. Based upon the interviews, a staff tried to comfort a child by touching the child's face softly with a staff's hand when the child woke up from nap because the child missed his/her parents. The incident was determined as unsubstantiated because LPA could not collect sufficient evidence to prove it happened or not.













This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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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