384000615-4-13-2022-05-CC-BVAN-CDG28V-20220413171057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000615
Report Date: 04/13/2022
Date Signed: 04/13/2022 05:12:13 PM

Document Has Been Signed on 04/13/2022 05:12 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:	K.E.E.P. INC.		FACILITY NUMBER:	384000615
ADMINISTRATOR:	SARKISIAN, MIMI		FACILITY TYPE:	840
ADDRESS:	2051 34TH AVENUE		TELEPHONE:	(415) 664-8685
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	63	CENSUS: 38	DATE:	04/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Mimi Sarkisian		TIME COMPLETED:	05:00 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 April 13, 2022, Licensing Program Analysts (LPAs) Van and Leong met with Director Mimi Sarkisian for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the Director. Present today are 38 children supervised by four teachers and the Director. The facility complies with the staff-children ratios today. The facility operates in a functioning SFUSD school site at R.L. Stevenson Elementary School. Operation of the school-age program is conducted in the school cafeteria. The days and operations hours are Mon, Tues, Thurs, and Fri from 2:05 pm to 6:00 pm; Wed 12:50 pm – 6:00 pm. LPAs toured and inspected the physical plant for any health and safety hazards. The facility is in good repair and has proper temperature and ventilation. Furniture appears steady and in good repair. The facility has a carbon monoxide detector, centralized smoke alarm, fully charged fire extinguishers, and working telephones. All emergency supplies are stored in locked storage. First aid supplies are fully stocked and available for children's usage. All cleaning solutions, poisons, and other dangerous chemicals are stored in an area inaccessible to children. The facility shares the bathrooms with the school. The girls' bathroom has four toilets and three sinks; the boys' bathroom has five urinals, two toilets, and three sinks. All toilets and handwashing sinks are in good working condition with proper sanitation. The outdoor play area is completely fenced, clean, and in good repair. LPA observed no bodies of water on the premises.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022

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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Document Has Been Signed on 04/13/2022 05:12 PM - It Cannot Be Edited

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: K.E.E.P. INC.	FACILITY NUMBER: 384000615
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day 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:
	Deficient Practice Statement
1 2 3 4	Based on record review, the facility did not comply with the section cited above in 4 out of 4 staff had their Mandated reporter expired, which poses/posed a potential health, safety, or personal rights risk to persons in care.
	POC Due Date: 05/13/2022
	Plan of Correction
1 2 3 4	The Director states she will ensure that all staff, current or new staff, complete the mandated reporter every two years. The Director says she will have all staff complete it by May 13 and submit it to the Licensing.

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the facility did not comply with the section cited above in 4 out of 4 staff had their Pediatric FirstAid CPR expired, which poses/posed a potential health, safety, or personal rights risk to persons in care.
	POC Due Date: 05/13/2022
	Plan of Correction
1 2 3 4	The Director states she will ensure at least one staff has valid Pediatric FirstAid/CPR. The Director plans to have multiple staff employed at the facility register and complete the Pediatric FirstAid/CPR by May 13, 2022. The Director says once the CPR is completed, she will submit the certificate to Licensing.

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 Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022

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: K.E.E.P. INC.	FACILITY NUMBER: 384000615
	VISIT DATE: 04/13/2022

NARRATIVE

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The facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Per the Director, The facility provides only snacks delivered by the SFUSD program. Water fountains are available for children at the Cafeteria and in the outdoor play area. The Director stated that the Center conducts fire and earthquakes every six months. The isolation area for an ill child is one corner of the Cafeteria, and the staff will monitor and supervise the child while parents are contacted to come and pick them up.

Ten random children's records and personnel records were reviewed during the inspection. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Staff records indicate that all staff or other individuals who require caregiver background checks have received criminal records and child abuse index clearances or exemptions. All staff maintained immunization records. LPA reviewed the educational qualification of the Director and staff, and all staff had the required ECE units.

At 3:10 pm, while reviewing staff records, LPAs found that all staff, including the Director Pediatric FirstAid/CPR, had expired, and all staff had expired Mandated Reporter Training.

The incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding 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: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022

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: K.E.E.P. INC.	FACILITY NUMBER: 384000615
	VISIT DATE: 04/13/2022

NARRATIVE

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The Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPA encouraged the Director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

During the inspection, LPA requested the Director to submit the following documents to the Department: Emergency Disaster Plan (LIC 610), Personnel Report (LIC 500), and the Designation of Administrative Responsibility (LIC 308), Mandated Reporter Certificate, and CPR of the Director. All documents should be submitted by May 13, 2022.

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 tools, please send them by email 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/inforesources/community-care-licensing/process.

See 809D for deficiencies cited today. An exit interview was conducted, and the report was reviewed with the Director, Mimi Sarkisian. Today's report, April 13, 2022, and notice of site visit will be sent to the Director by email by the close of business on April 13, 2022. Confirmation of receipt is required. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022

LIC809 (FAS) - (06/04)

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