384000669-11-1-2022-05-CC-CQUO-CKRRGN-20221101130100

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000669
Report Date: 11/01/2022
Date Signed: 11/01/2022 01:01:33 PM

Document Has Been Signed on 11/01/2022 01:01 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-DOLORES HUERTA ELEMENTARY SCHOOL (EES)		FACILITY NUMBER:	384000669
ADMINISTRATOR:	RODRIGUEZ, LUIS		FACILITY TYPE:	850
ADDRESS:	65 CHENERY STREET		TELEPHONE:	(415) 379-2700
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	24	CENSUS: 15	DATE:	11/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Lorena Contreras		TIME COMPLETED:	01:15 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 November 1, 2022 at approximately 10:55am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with lead teacher, Lorena Contreras, and explained the purpose of the inspection. Present during LPA's visit included lead teacher, 2 para professionals, and 15 enrolled children. Facility is operating within capacity limits and ratio during LPA's visit. Preschool program operates at Dolores Huerta Elementary in classroom C205 only. Hours of operation are Monday through Friday from 8:40am to 2:55pm. All working staff on site are fingerprinted through San Francisco Unified School District. At approximately 11:00am, LPA inspected the preschool program, indoors and outdoors, for health and safety hazards. Classroom is equipped with a working telephone, emergency supplies, fully charged fire extinguisher and a working carbon monoxide detector. Entire facility has a smoke and fire alarm system implemented by school district. LPA observed cleaning solutions, poisons and other chemicals to be made inaccessible to children in classroom's high shelves. Storage for children's belongings is located inside the classroom, labeled with children's individual names. Classroom has age appropriate furniture, toys and materials that were clean and in good working condition. Classroom also has class pet chicks that are properly caged and barricaded from enrolled children in care. There is one bathroom in the classroom, with two sinks and two toilets. LPA observed bathroom to be in working condition with appropriate sanitation products. Sinks in bathroom do not provide water that is warmer than 120 degrees Farenheit. LPA observed classroom to be equipped with garbage, recycling, and compost bins to have tight fitting lids. LPA observed electrical outlets to be made inaccessible, blocked by furniture. Children are signed into and out of program with parent's written signatures. LPA observed all children present to be properly signed into program. All licensing documentation is properly posted in front entrance of classroom, available for review. (Continue on Page 2....)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

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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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-DOLORES HUERTA ELEMENTARY SCHOOL (EES)	FACILITY NUMBER: 384000669
	VISIT DATE: 11/01/2022

NARRATIVE

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Water is made accessible to children, indoors and outdoors, with children's individual water containers. LPA observed facility to also have accessible water fountains on site.

Preschool program is part of facility's food program. All food is stored and prepared in facility's kitchen to avoid contamination. Children are also able to bring their own food, that is stored in children's individually labeled cubbies. Classroom has sufficient amount of sleeping cots that are utilized for nap time. Children's sheets are stored in their individually labeled backpacks, provided by school district's PTA.

Preschool program has exclusive use of an outdoor area that is made separate from entire school's outdoor play area. LPA observed play area utilized for preschool program to be fully enclosed and fenced with an at least 4 ft. high fence. LPA observed outdoor area to have age appropriate materials that are in good working condition. Playground was observed to have age appropriate climbing structures with resilient padding underneath.

LPA reviewed 5 children's files, head teacher's and para-professional's files. Children's and staff files were complete. Head teacher's CPR and First Aid certificate is current and will expire 02/2023.

Head teacher was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Head teacher 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.

Head teacher is aware that all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. LPA encourages the head teacher to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

LIC809 (FAS) - (06/04)

Page: 2 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: SFUSD-DOLORES HUERTA ELEMENTARY SCHOOL (EES)	FACILITY NUMBER: 384000669
	VISIT DATE: 11/01/2022

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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/inspection-process.

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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies were issued under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with head teacher, Lorena Contreras.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

LIC809 (FAS) - (06/04)

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