384000199-10-19-2022-05-CC-LGOZ-CKD2F6-20221019172100

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000199
Report Date: 10/19/2022
Date Signed: 10/19/2022 05:21:20 PM

Document Has Been Signed on 10/19/2022 05:21 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:	CHILDREN'S DAY SCHOOL, INC.		FACILITY NUMBER:	384000199
ADMINISTRATOR:	GREENE, ANTONETTE B.		FACILITY TYPE:	850
ADDRESS:	333 DOLORES STREET		TELEPHONE:	(415) 861-5432
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	72	CENSUS: 45	DATE:	10/19/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Antonette Greene		TIME COMPLETED:	05:30 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	On 10/19/2022 at 1:45PM., Licensing Program Analyst (LPA), Luis J. Gomez met with Director, Antonette Green. Purpose of the inspection was explained and was for an unannounced; Annual/ Random inspection. Present was the director and 9 staff supervising 45 children. Staff have their have criminal record clearances on file. Children present have been signed in. Preschool program utilizes three classroom: Leap Lizards; Teddy Bears; Starfish; and two Outdoor Play Area: Shared and Covered Patio Area. Day and hours of operation are Monday- Friday, 8:00AM- 5:00PM. LPA inspected facility, indoors and outdoors, for health and safety hazards. At 1:55PM., LPA observed the following: Facility was clean, orderly, with age-appropriate playthings available for the children. Floors and ground surfaces leading to the exits were free of obstruction. Accessible furniture, books and materials inspected were in good repair. Classroom is equipped with labeled cubbies and cabinets for added storage. Classroom had several child sized tables and chairs for snack and activities. Children’s bathroom had adequate supplies for hand washing. Fixtures tested were operating condition. Staff bathroom is located separate. For napping services, foldable mats are stored in each classroom. Per director, napping supplies are washed weekly by families. Facility has acceptable ventilation and lighting. Detergents; cleaning supplies/ compounds; and toxins are stored in the off-limit areas. Electrical outlets, heater vents are properly covered. Classrooms had functioning carbon monoxide detector and fire extinguishers; 2A:10BC. Per director, facility provides snack for all children. Food items were reviewed during inspection. All food items inspected current and properly stored. At 2:20PM., LPA inspected facility’s outdoor play areas. Areas are completely enclosed. Per director, water services are provided with nearby water fountain and paper/ refillable cups. Facility does not have any pools, jacuzzis, fish ponds or bodies of water on site. LPA reminded director to ensure damaged tricycles are replaced or repaired. (REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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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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: CHILDREN'S DAY SCHOOL, INC.	FACILITY NUMBER: 384000199
	VISIT DATE: 10/19/2022

NARRATIVE

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At 2:50PM, LPA reviewed the facility records including five children’s files and six personnel files. Staff files reviewed included the: Notice of Employee Rights (LIC9052); Criminal Record Statement;; and Declaration to Report Suspected Child Abuse (LIC9108).

At 3:30PM., Based on record review, LPA confirmed staff's proof of qualifications are missing from staff files. Advisory Note: Technical Violation (LIC9102TV) was issued during inspection.

LPA reminded director to ensure all staff have updated required mandated reporter training (AB1207), and proof of required immunization are stored in personnel files.

Children’s files were reviewed and included the signed: Consent for Medical Treatment (LIC627); Identification of Emergency Information (LIC700); Health History (LIC702); Notification of Parent’s Rights (LIC995); and Physician's Report (LIC701).

LPA reminded director that all CPR/ First Aid training's for staff must be EMSA/ AMA Certificated. Emergency disaster drills are conducted, with last drill done on 10/19/2022.

Required forms and posted in facility: Childcare License; Child Passenger Safety Laws; Notification of Parent’s Rights (PUB394); and Emergency Disaster Plan (LIC610). Per director updated snack menu is send to families via email.

Children’s medication and incident medical services (IMS) was discussed with director.

For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
(REFER TO 809C FOR CONT.)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: CHILDREN'S DAY SCHOOL, INC.	FACILITY NUMBER: 384000199
	VISIT DATE: 10/19/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tool, please send them to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesource/community-care-licensing/inspection-process.

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview and report was reviewed with Director, Antonette Greene and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice of site visit was provided and must remain posted for 30 days. Any additional questions facility was advised to call Regional Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

LIC809 (FAS) - (06/04)

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