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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001376
Report Date: 12/11/2019
Date Signed: 12/11/2019 11:44:54 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:SERRA PRESCHOOL, THEFACILITY NUMBER:
384001376
ADMINISTRATOR:MARYBETH CODYFACILITY TYPE:
850
ADDRESS:7 FUNSTON AVENUETELEPHONE:
(415) 561-2200
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94129
CAPACITY:47CENSUS: 37DATE:
12/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Marybeth CodyTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mok, conducted an unannounced increased inspection today. LPA met with the owner/Site Director, Marybeth Cody and Assistant Site Director, Victoria Dudley. The purpose of the inspection was explained to them, There were 37 children with 7 staff present. All staff have fingerprint clearance. This facility runs a Preschool Program in Rooms #115, #110, #111, #202 (Pre-K), # 104 (Snack room), # 103 (Gross motor room), #211 (Art Room), and 219 (Block Room). The facility has an outdoor play yard behind the building. The operation hours of the facility are Monday to Friday from 8 AM to 5 PM. The program has two sessions: morning from 9:00am to 12:00pm; afternoon from 1:00pm to 4:00pm. The main entrance of the facility is on Mesa Avenue instead. Facility provides curb side drop off/ pick up service at the Mesa Avenue entrance. LPA toured and inspection the facility for health and safety hazard. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. All electrical outlets were covered. There were plenty of age-appropriate toys, books, learning material, art material, and children's furniture available for children. Window locks have installed to all windows in each classroom. Children bring their own lunch to school. Facility provides snacks to the children only. There are bathrooms with 3 toilets and 3 sinks for children in the main floor. One bathroom is available for children in the second floor. Separate Staff bathrooms are available in the building. Gates are available on the stairways. No apparent health or safety hazards were noted in both the indoor and the outdoor play areas. Per Marybeth, there was no guns, weapons, and pets in the facility. The outdoor play yard was completely fenced. There were some age-appropriate toys, ride-on toys, and children's furniture available for the children. Per Marybeth, there was a child on special medication. This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative record. For IMS Information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. At least one staff had current CPR/First Aid training certificate available for review during the inspection. It will expire in 8/2020. Disaster Drill has been conducted at least 2 times a year. The latest drill was conducted on 11/5/19. All staff completed the Child Abuse Mandated Reporter Training (AB1207) & the General Training. The certificates were reviewed during the inspection. Ten children's file were reviewed during the inspection. Sign in/out sheets were reviewed during the inspection. LPA also obtained a copy of the current children roster from licensee 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: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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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