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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000352
Report Date: 08/29/2022
Date Signed: 08/29/2022 03:44:29 PM


Document Has Been Signed on 08/29/2022 03:44 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:YMCA OF SF., RICHMOND BRANCH, ARGONNE SITEFACILITY NUMBER:
384000352
ADMINISTRATOR:ALEXANDRA ZUSSMANFACILITY TYPE:
840
ADDRESS:680 18TH AVENUETELEPHONE:
(415) 831-4093
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:200CENSUS: 66DATE:
08/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Stephanie BrennanTIME COMPLETED:
04:10 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the Site Coordinator, Stephanie Brennan. The purpose of the inspection was explained to her. There were 66 children with 5 Staff present. All aduits had fingerprint clearance. The executive Director, Grance Ih, was in charge of this site, but she was not available at the site during the inspection. The program was operated in a functioning school site Argonne Elementary School. Facility was licensed for rooms 107, 107A, 107B, 201- 209, 301-304, multi-purpose room, and the outdoor playground. The outdoor spaces were shared with other two after school program with different schedule. Per Stephanie, the program used Room #201, 302, multi-purpose room, and a classroom in multi-purpose room for current school year. Facility met teacher/child ratio today. LPA toured the facility for health and safety hazard. Variety of age appropriate toys and materials for children were available in the classroom. Classrooms were set up for child care. Furniture and equipment for children were available as well. Toxins and harmful objects were made inaccessible to children. The outdoor playground was completely fenced. There were some play structure with soft cushioning underneath. There were couple water fountain at the playground available for the children. Children's bathroom were cleaned. The facility provided snacks to children only. First aid supplies were available in the classroom. Isolation area will be the couch at the corner of the classroom or the teacher's desk area. At least one staff has current pediatric CPR and First Aid training, it will expire in 11/2023. Facility has posted the required postings. Fire and Earthquake drills were done every monthly. LPA reviewed the children and staff files during the inspection. LPA also obtained a copy of the current children's roster from the facility during the inspection. Per Stephanie, there was a child on special medication. LPA inspected the medication and document during the inspection.

There is no deficiency cited against the facility under CCR,Title 22, Div. 12, Chapt. 1:

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.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2022
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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