384000093-1-27-2020-05-CC-BVAN-BL8S4B-20200127123227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000093
Report Date: 01/27/2020
Date Signed: 01/27/2020 12:32:35 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:	LITTLE STAR PRESCHOOL "TOO"		FACILITY NUMBER:	384000093
ADMINISTRATOR:	ALYCIA MOY		FACILITY TYPE:	850
ADDRESS:	1105 QUINTARA STREET		TELEPHONE:	(415) 731-7933
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	104	CENSUS: 86	DATE:	01/27/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Derrick Moy		TIME COMPLETED:	12:45 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 Analyst (LPA) Van met with the teacher, Derrick Moy, for an unannounced annual random inspection. The purpose of the inspection was explained and was granted entry to the facility by the director. This facility is a preschool program. Present today are 86 children with 8 teachers. Staff to children ratio are met. The indoor and outdoor areas were inspected today for health and safety hazards. There are two large classrooms, the sunflower room and the Daisy room. Each class has a bathroom for children with 3 toilets, 1 urinal, and 4 sinks in each. There is another separate bathroom next to the kitchen available for children. A different staff bathroom is available for staff. Days and hours of operations are from Monday - Friday 7:15 AM - 6:00 PM. Per the teacher, there are no firearms, weapons, or pets at the center. Sick children will be separated from the group and waited in the Director’s office for parents to pick up. Per the teacher, the center provides two snacks and lunch for children. The children's foods are catered from the Three Stars Restaurant. The facility has several water fountains indoor and outdoor available for children. The teacher stated that Fire and Earthquake drills are done monthly. The last fire drill was completed on 12/18/2019. With the teacher, LPA inspected the daycare areas for health and safety hazards. The following were observed the following; • The facility has a sign-in / out record with full legal signatures from the parent or authorized representative. • The facility is in good repair, free of any hazards, and has proper temperature and ventilation. • A variety of age-appropriate toys and learning materials for children are available. • The classroom is set up for childcare; furniture, equipment, sufficient amount of sleeping mats for children are available. • All children's chairs and tables have rounded corners. • There are no pools, spas, or other bodies of water at the facility. • The facility has a smoke detector, and a carbon monoxide detector fully charged

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2020

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: LITTLE STAR PRESCHOOL "TOO"	FACILITY NUMBER: 384000093
	VISIT DATE: 01/27/2020

NARRATIVE

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fire extinguisher and a working telephone at the site.
• All cleaning solutions, poisons, and other chemicals that are dangerous stored inaccessible to children.
• The food preparation area is clean, organize, and foods store appropriately.
• The outdoor playground area is in good repair. Play structures are free of any loose parts, and there is a small sandbox.
• There are menus and daily activities posted
• The 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).

The following records were reviewed:
• All staff have criminal record clearance.
• All staff have a record of valid Pediatric FirstAid/CPR card in file.
• Staff have the required immunization and verification of the mandated child abuse reporting training as compliant with AB1207.
• Incidental Medical Service (IMS), LPA reviewed medications storage and discussed with director paperwork needed on the child's plan.
• All children had a medical assessment, and required licensing forms were completed. Medication Policies, Isolation of Sick Children, and Napping Requirements.

The following were discussed with the teacher:
• Provider Information Notices (PINs) on CCLD website, Mandated Reporter Training, and Immunization (as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662). ADA was provided; US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication. Pesticides training was also discussed (Information on the DPR website at www.cdpr.ca.gov/shoolipm/childcare),
• LPA went over the Child Care Center checklist and provided a copy to the Director during the inspection

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 the 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: 01/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2020

LIC809 (FAS) - (06/04)

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