384000615-11-2-2023-05-CC-JTSE-CX7VGC-20231102162518

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000615
Report Date: 11/02/2023
Date Signed: 11/02/2023 04:25:29 PM

Document Has Been Signed on 11/02/2023 04:25 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
SAN BRUNO CC RO, 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: 43	DATE:	11/02/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	02:01 PM
MET WITH:	Mimi Sarkisian		TIME COMPLETED:	04:45 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 11/2/2023, at approximately 2:01PM, Licensing Program Analysts (LPAs) Jonathan Tse and Brendon Van conducted an unannounced annual visit at the facility. LPAs were granted entry to the facility by Site Director Mimi Sarkisian. LPAs explained the purpose of the visit to Site Director. Present during the visit were five staff and 43 school-age children. The facility is in compliance with teacher-child ratios. LPAs and Director inspected the facility for any health and safety hazards. The facility is located within the grounds of Robert Louis Stevenson School, and uses the school’s cafeteria and yard. There is a fully charged 2A10BC fire extinguisher present in the facility. Director demonstrated the carbon monoxide detector within the facility to be operational during the visit. LPAs observed age-appropriate toys and art supplies to be present. All poisons and chemicals are stored inaccessible to children. The facility shares bathrooms with the school. The girls’ bathroom has four toilets and three sinks. The boy’s bathroom has five urinals, two toilets, and three sinks. All toilets and hand washing stations are in good working condition, and in good repair. The facility uses the same yard as the school, with appropriate play equipment available for use. LPAs observed the yard to be free of debris. All required postings are posted in an accessible area of the cafeteria. LPAs reviewed five staff files and seven children’s files. LPAs found all children’s files to be complete. Staff files have current Mandated Reporter Training certificates. The facility has not conducted an emergency drill since the beginning of the school year. At the end of the school day, children are escorted to the cafeteria by facility staff. Children are signed out by facility staff as they are picked up. Children’s medications are stored in the facility’s storage room, and are properly labeled and kept in their original packaging. The facility offers snacks that are provided by SFUSD. Per director, the facility is a nut-free facility. There is a water dispensing station in the cafeteria that is used by all children. Continued on Page Two

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: K.E.E.P. INC.	FACILITY NUMBER: 384000615
	VISIT DATE: 11/02/2023

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs discussed the process of signing up for Guardian to associate employees to the facility with director.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

The facility has not conducted water lead testing before the deadline of 1/1/2023. LPAs referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. LPAs discussed lead testing requirements and the procedure of conducting lead testing with director.

Continued on Page Three

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: K.E.E.P. INC.	FACILITY NUMBER: 384000615
	VISIT DATE: 11/02/2023

NARRATIVE

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LPAs discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

See LIC809-D for deficiency cited today.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were given and reviewed with director.

Exit interview conducted and report was reviewed with the director, Mimi Sarkisian.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 11/02/2023 04:25 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
SAN BRUNO CC RO, 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: 11/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above by not conducting water lead testing before the deadline of 1/1/2023, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/01/2023
	Plan of Correction
1 2 3 4	Per director, she will communicate lead testing requirements with the principal of Robert Louis Stevenson Elementary School. Director will find out if SFUSD has already conducted testing, and if so, will submit results to LPA. If SFUSD has not conducted lead testing, director will communicate the principal's plan to LPA for further steps.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

LIC809 (FAS) - (06/04)

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