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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001019
Report Date: 02/08/2022
Date Signed: 02/08/2022 01:05:38 PM

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:KAI MING HEAD START-RICHMONDFACILITY NUMBER:
384001019
ADMINISTRATOR:RFACILITY TYPE:
850
ADDRESS:426 33RD AVENUE, 2ND FLOORTELEPHONE:
(415) 386-3096
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:30CENSUS: 15DATE:
02/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Kelly LiTIME COMPLETED:
01:20 PM
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LPA Mok conducted an unannounced annual inspection today. LPA met with the Site Director, Kelly Li, The purpose of the inspection was explained to her. The Preschool program operates in the Pine Methodist Church. Present at the facility were 6 other. There were 15 children with 6 staff present today. All adults were fingerprinted. Facility met teacher/child ratio today. The indoor areas were inspected today for health and safety hazards. No apparent hazards were observed. There were 3 classrooms such as Classroom 1, 2, and multipurpose classroom that next to the office. There were plenty of the age-appropriate toys, books, learning equipment and children's furniture available in each classroom. The children's furniture was in good repair and condition. There was a sink in classroom #1 & #2 available for the children. There were the two children's bathrooms on site, the girl's and the boys, with total of three toilets, one urinal and three sinks were available for children. All toilets and sinks were reachable by children. All hot water on all children's sink were shot off, only has cold water. Cubbies were available for children's use. Separated staff bathrooms were available for staffs on the lower level share with the ABC preschool staffs. Isolation area for ill child was the director's office. Facility has an outdoor play area on the lower level with an outdoor space waiver for no more than 20 child at a time; Facility also use the public park near by for outdoor play every day if weather permits. Facility was clean and orderly today. Cots were available for napping, parents take the blankets home to wash every Friday. Facility provides breakfast, lunch and snack for children via Chefable. The food preparation areas was clean and in order. The food waste bins had tide lids. Drinking water is readily available with cups for children indoor and outdoor, staffs bring water bottle with cups for outdoor. Facility has posted the required forms (ie License, menus, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). Fire and Earthquake drills are done each month and are properly logged. All Children have signed in today. Most staff at the facility have current CPR & First Aid training. All staff had current Mandated Reporter Training certificate for review The facility had hand sanitizer, touchless thermometer, disinfectant, and face mask
This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
s for Adults & Children available to prevent COVID19
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2022
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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