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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000221
Report Date: 11/15/2022
Date Signed: 11/15/2022 03:05:14 PM


Document Has Been Signed on 11/15/2022 03:05 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-STARR KING EARLY EDUCATION SCHOOL (PS)FACILITY NUMBER:
384000221
ADMINISTRATOR:GREG JOHNFACILITY TYPE:
850
ADDRESS:1215 CAROLINA STREETTELEPHONE:
(415) 695-5570
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94107
CAPACITY:23CENSUS: 0DATE:
11/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Christina QuirozTIME COMPLETED:
03:20 PM
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On 11/15/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the SFUSD Starr King Preschool facility. The LPA was granted entry by a office staff member, Christina Quiroz. The LPA explained the purpose of the visit to the office staff member. SFUSD, the school district's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. During the visit, there was no staff or children present in the facility.

The LPA performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA observed that the playground equipment and outdoor furnishings are in excellent condition. The outdoor play structure is surrounded by rubberized cushions, which can cushion any falls that may occur. The LPA noted that there were no bodies of water present at the facility. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order.

The LPA observed that the facility had displayed all the required documents (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

Files pertaining to the staff and children were not reviewed because there were no children or staff present in the facility.

No deficiencies were issued today. A copy of this report, and the “Notice of Site Visit, “were given to the office staff. A Notice of Site Visit must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. ** See Page 2 for continuation***

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson LeongTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


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: SFUSD-STARR KING EARLY EDUCATION SCHOOL (PS)
FACILITY NUMBER: 384000221
VISIT DATE: 11/15/2022
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Continued, Page 2
An exit interview was conducted, and the report was reviewed with the office staff member, Christina Quiroz,
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson LeongTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2