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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001093
Report Date: 08/29/2022
Date Signed: 08/29/2022 01:08:10 PM


Document Has Been Signed on 08/29/2022 01:08 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:EPIPHANY PARENT-CHILD CENTERFACILITY NUMBER:
384001093
ADMINISTRATOR:LYNETTE JONESFACILITY TYPE:
830
ADDRESS:100 MASONIC AVENUETELEPHONE:
(415) 567-8370
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:39CENSUS: 10DATE:
08/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Lynette JonesTIME COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the Site Director, Lynette Jones. The purpose of the inspection was explained to her. There were 10 children with 4 staff present. All adults had fingerprint clearance. The facility was located in the Mount St. Josephe-St. Eilzabeth Epiphany Center. The indoor areas were inspected today for health and safety hazards. No apparent hazards were observed. Facility has total of two rooms (#8 - Sunshine and #7 - Humming Bird) on the ground floor. Per Lynette, the room #7 for the youngest child was closed for construction during the inspection. The ceiling of the room was damaged by the water leak from the 2nd floor. The room should be available by 9/2/2022. All the children were in room #8. There was a separated nap areas available for infants in the room with cribs that were labeled with each child's name. Cots were available for older children as well. There was a changing tables available in each classroom; Children's bathroom in Room #8 had one toilet and two sinks and some potty chairs were available for children. Cubbies were available for children's use. Separated staff bathrooms were available for staffs on site. Isolation area for ill child was one of the empty rooms. Facility was clean and orderly today. There were plenty of age-appropriate toys, books, learning equipment and material, and children furniture that were in good repair and condition. All toys and equipment were washed every day with soap and sanitizer. The facility has washed all blankets and sheets every week or as needed. Facility has provided formula and food to all children. The facility had a on-site kitchen to prepare the food for the children. LPA inspected the kitchen and the food storage areas during the inspection. High chairs were available for feeding only. Facility had its own outdoor space for infant and toddlers. The Outdoor was completely fenced. There were some age-appropriate outdoor toys, sandbox, and play structures with soft cushioning underneath available for children. Drinking water was readily available for children indoor and water cups for outdoor. All the required postings were posted. The emergency drill has been conducted at least 2 times a year and logged. LPA reviewed the staff and children's files during the inspection. LPA also obtained a copy of the children's roster from the facility during the inspection. There were no children on special medication. At least one staff had current CPR/First Aid Training. LPA also inspected the 15 min. check log during the inspection. LPA discussed important information for the 15 min. log with the Site Director during the inspection. LPA inspected the sign in/out sheet during the inspection.

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
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2022
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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