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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000958
Report Date: 10/20/2022
Date Signed: 10/20/2022 09:40:43 AM


Document Has Been Signed on 10/20/2022 09:40 AM - 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:FAMILY SCHOOL CDC BERNAL GATEWAY, THEFACILITY NUMBER:
384000958
ADMINISTRATOR:HAYNES, MARILYNFACILITY TYPE:
830
ADDRESS:3101 MISSION STREETTELEPHONE:
(415) 550-4178
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:16CENSUS: 7DATE:
10/20/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Patricia Bacerra, Amalia JustoTIME COMPLETED:
09:50 AM
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On 10/20/2022 at 8:35AM., Licensing Program Analyst (LPA) Luis J. Gomez met with Lead Teacher, Amalia Justo. Director, Patricia Bacerra arrived during inspection. Purpose of the inspection was explained and was for an unannounced; Plan of Correction inspection. Present was the director and three staff supervising and 7 children. Children present have been properly signed in. LPA inspected facility for health and safety hazards.

During today’s inspection, LPA performed observations, record review and interviewed staff.

At 8:45AM., LPA observed infant and toddler classrooms have a fully qualified teacher present. Program is operating within the required teacher- child ratio on this day.

LPA observed napping logs for infant-age children in care. Per staff, logs are updated every 15 minutes and document the date, time, name, sleeping position, and any visual signs of distress.

Deficiencies issued on 10/12/2022, has been cleared and ‘Cleared Plan of Correction Letter’ was provided.

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was discussed with Director, Patricia Bacerra and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Principal was advised for additional questions to contact the CCL Office, M-F, 8:00AM- 5:00PM, 650-266-8800 or 1-844-538-8766.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2022
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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