<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000867
Report Date: 04/16/2021
Date Signed: 04/16/2021 11:48:48 AM

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:MISSION HEAD START-WOMEN'S BUILDING CENTERFACILITY NUMBER:
384000867
ADMINISTRATOR:REYES, CINDYFACILITY TYPE:
850
ADDRESS:3543 18TH STREETTELEPHONE:
(415) 701-1995
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:23CENSUS: 6DATE:
04/16/2021
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Senior Director of Children Services, Cyndee Nieves TIME COMPLETED:
11:50 AM
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 4/16/2021 at 11:20A.M. Licensing Program Analysts (LPAs), Luis J. Gomez and Sheran Lo met with Senior Director of Children Services, Cyndee Nieves at the Mission Neighborhood Center Headquarters on 362 Capp Street, San Francisco, CA 94110. Purpose of the inspection was explained and is for a case management inspection. Present is the Director and three staff providing care for six children. All children are preschool age. Immediate Exclusion letter for Jace Wong was hand delivered during inspection.

No deficiencies were cited today against the facility under CCR, Title 22, Div. 12, Ch 1.

This report and rights to comment and appeal were discussed with Administrator. This report must be available in the facility for public review.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2021
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 1