<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001634
Report Date: 09/10/2024
Date Signed: 09/10/2024 10:12:13 AM

Document Has Been Signed on 09/10/2024 10:12 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MISSION HEAD START - VALENCIA GARDENSFACILITY NUMBER:
384001634
ADMINISTRATOR/
DIRECTOR:		CHRISTINA SAMUELFACILITY TYPE:
850
ADDRESS:380 VALENCIA STREETTELEPHONE:
(415) 552-0169
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY: 36TOTAL ENROLLED CHILDREN: 26CENSUS: 20DATE:
09/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:39 AM
MET WITH:Solman ManaTIME VISIT/
INSPECTION COMPLETED:
10:25 AM
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 September 10, 2024, at approximately 8.45am, Licensing Program Analyst (LPA) Tso conducted an unannounced case management visit for the outdoor playground renovation project and met with the Lead Teacher, Solman Mana. Present during the inspection was 9 teachers, caring for 20 children.

On September 9, 2024, LPA received an email issued by the Director to inform the outdoor playground renovation had been completed. LPA observed that the renovation of the outdoor playground area has been completed. The outdoor playground area is in good repair and completely fenced for supervision. The play structures are age-appropriate and in good condition, with sufficient cushioning underneath, such as artificial grass. LPA did not observe any pools, jacuzzi, fishponds or bodies of water in the outdoor playground area.

Prior to recommended for approval for use of the outdoor playground, the facility must complete the following for review:

· Proof of cleaning up the debris on the floor, clean up the play structures and equipment, and removal of the shovel to the off-limit areas that cannot be accessed by the children.
· Proof of adding the corner protectors or smoothing corners of the storeroom. There are 4 corners involved.
· Proof of adding cushion or smoothing the cut areas of the trees. There are 4 cuts involved.
· Proof of adding cushion or smoothing the 2 corners of the wooden cover for the compressor, and a corner of the cement ground.

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 Lead Teacher.

Notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Lead Teacher, Solman Mana.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1