384001263-4-8-2024-05-CC-MTSO-D45QBC-20240408120119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001263
Report Date: 04/08/2024
Date Signed: 04/08/2024 12:01:25 PM

Document Has Been Signed on 04/08/2024 12:01 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	JCCSF HELEN DILLER FAMILY PRESCHOOL		FACILITY NUMBER:	384001263
ADMINISTRATOR:	CIANCI, KARLA		FACILITY TYPE:	850
ADDRESS:	3200 CALIFORNIA STREET		TELEPHONE:	(415) 292-1291
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94118
CAPACITY:	175	CENSUS: 0	DATE:	04/08/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:52 AM
MET WITH:	Karyn Khan		TIME COMPLETED:	12:15 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 April 8, 2024, at approximately 8:30am, Licensing Program Analyst (LPA) Tso made an unannounced required visit to the child care center listed above. The LPA was granted entry by the Assistant Director, Karyn Khan (Director). The Director was informed of the reason for today's visit by the LPA. Present the school is on spring break from April 8-12, 2024. There are no children in the facility during today visit. The Facility is operating from 10 classrooms: 104,107, 109, 110, 111, 124, 125, 306, 308, and 310. Hours of operation are Monday- Friday, 8:10 am- 5:00 pm. LPA assessed the Center for Health and Safety Hazards with the Director. Per Director, there are no changes to the existing physical plant. The facility maintains a record of sign-in/out for children. The children's classroom environment appeared clean and organized, with appropriate heating, lighting, and ventilation. The Center also provided age-appropriate toys, furnishings, changing tables, and equipment. LPA did not observe any pools, spas, or other bodies of water at the facility. According to the Director, no firearms or weapons are present at the Center, and all cleaning materials and potentially hazardous objects are kept out of reach of children. Personnel restrooms are separate from children, and all solid waste storage containers have tightly fitted lids. The Center also maintains multiple carbon monoxide detectors, centralized smoke alarm, fully charged fire extinguisher, and First Aid kit. Designated cubbies are available for children to store their belongings. There is sufficient sleeping equipment and cots for each child, and all mats and bedding are kept in the appropriate location. LPA also observed that the food preparation site is clean, organized, and inaccessible to children. LPA observed that the outdoor playground area is in good repair and completely fenced for supervision. The play structure is age-appropriate and in good condition, with sufficient cushioning underneath. The sandbox was covered properly. (Continued on page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: JCCSF HELEN DILLER FAMILY PRESCHOOL	FACILITY NUMBER: 384001263
	VISIT DATE: 04/08/2024

NARRATIVE

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(Continued, page 2 …)
LPA checked a personnel record (the other files were locked during the spring break period), and children's records at the facility. A sample of children's files was found to contain comprehensive information such as medical assessments, needs, services, feeding plans, and signed admission agreements. The staff file was also well-organized and thorough, with Mandated Reporter Training Certificate (AB1207) valid until 8/24. The staff member was observed to have valid CPR/First Aid cards and vaccine proofs for Measles, Pertussis, and Influenza in the file. Additionally, the facility had posted the required documents, including the license, menus, waivers, Notification of Parental Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. The most recent emergency drill was held on March 29, 2024.

LPA discussed the safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reminded the Director that as of September 1, 2016. A person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles.

The Incidental Medical Services (IMS) policy was discussed. LPA reviewed storage of medication and equipment/supplies and remind the Director to ask the parents to replace the valid medication. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care
Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

The Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: JCCSF HELEN DILLER FAMILY PRESCHOOL	FACILITY NUMBER: 384001263
	VISIT DATE: 04/08/2024

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5 years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA refer to other LPA’s contacts with the facility on 3/19/2024, the water fixture “T” retested for lead exceeds 5.5 ppb threshold on 3/7/2024. Per the lead project staff of the facility. The affected fixture T’s faucet has been replaced and installed a filter. The facility would keep on figuring it out by option 1, permanently removed or option 2, considering any other means.

The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to be completed every two years by all staff hired a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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/process.

There were no deficiencies cited at this time under CCR, Title 22, Div. 12, Chapter 3. A copy of today’s report was given to the Assistant Director.
Notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Assistant Director, Karyn Khan.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024

LIC809 (FAS) - (06/04)

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