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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000274
Report Date: 11/08/2019
Date Signed: 11/08/2019 01:51:33 PM

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:FAMILY CONNECTIONS CENTERS - PRESCHOOLFACILITY NUMBER:
384000274
ADMINISTRATOR:TAM, TINAFACILITY TYPE:
850
ADDRESS:2565 SAN BRUNO AVENUETELEPHONE:
(415) 715-6746
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:18CENSUS: 14DATE:
11/08/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Tina TamTIME COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Faye Bremer conducted an unannounced Annual inspection. LPA met with Education Director Tina Tam and explained purpose of inspection. This preschool operates in one classroom inside the Family Connections Center. There were 14 preschoolers with 2 teachers present upon LPA's arrival during the morning session. There were 16 preschoolers present with 2 teachers present during the afternoon session.

This is a a half-day program, with a morning preschool session which runs from 9:00am-12:00pm, and an afternoon preschool session which runs from 12:30pm-3:30pm. LPA toured and inspected the classroom for health and safety hazards. LPA observed the classroom to be clean and orderly, with sufficient age appropriate toys, books, equipment, and furniture available for children. Classroom was at a comfortable temperature, with adequate lighting and ventilation. All sharp corners were covered with soft cushioning. Building and classroom has hard-wired fire alarm and sprinkler system. First aid kits are available and complete in the classroom. There is an aquarium with turtles in the classroom. Classroom has 2 children's bathrooms, each with 1 toilet and 1 sink available. Bathroom was observed to be clean and in good repair. There is a food preparation area with refrigerator in the back of the classroom. LPA observed toxins and disinfectants unlocked under classroom sink and accessible to children. Children's water fountain with attached sink is available in the classroom. Since this preschool operates in morning and afternoon sessions, no meals are provided, only snacks, and children do not nap. Cubbies are available for each child. Children's medication is stored in a cabinet above the teacher's desk. The facility has an outdoor exemption for NO outdoor area. Children go to the park nearby when weather permits. Per Education Director, preschool goes to the library once a week. Discipline policy was discussed, which is redirection and positive reinforcement.

Continues on following LIC809C page.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye BremerTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
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 3
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: FAMILY CONNECTIONS CENTERS - PRESCHOOL
FACILITY NUMBER: 384000274
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2019
Section Cited

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Buildings and Grounds - Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. Storage areas for poisons shall be locked.
This requirement is not met as evidenced by:
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Based on observations, disinfectant was stored unlocked in classroom under sink. Licensee failed to ensure that disinfectants and cleaning solutions are locked and inaccessible to children, which poses a potential Health and Safety threat to children in care.
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POC to be received in CCLD office BY 11/15/2019
Type B
11/15/2019
Section Cited

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Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion - On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
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Based on staff records review, staff do not have proof of completed Mandated reporter training. Licensee failed to ensure staff have completed mandated reporter training, which poses a potential health and safety risk.
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of the completed Mandated Reporter training to CCL.

POC to be received in CCLD office BY 11/15/2019
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye BremerTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: FAMILY CONNECTIONS CENTERS - PRESCHOOL
FACILITY NUMBER: 384000274
VISIT DATE: 11/08/2019
NARRATIVE
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Continued from previous page.

LPA reviewed children and staff records. All children's files reviewed have all required assessments, agreements and signed forms on file. Staff have current CPR/First Aid Training which expires on 08/2020. Staff do not have approved completed Mandated Reporter training. Sign in and out sheets were reviewed. Fire/ Emergency drills were conducted and logged, with last drill conducted on 9/9/2019. All required postings are posted in the facility. LPA also reviewed and obtained a copy of the current children roster. Staff has all required immunizations on file. This facility does not curently provide any Incidental Medical Services (IMS) to children.

Deficiencies cited today under California Code of Regulations, Title 22, Div 12, follows on LIC 809D.
Appeal Rights given.
Report reviewed and discussed with Tina Tam
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye BremerTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3