384001884-1-15-2020-05-CC-MROZ-BKV2MZ-20200115163159

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001884
Report Date: 01/15/2020
Date Signed: 01/15/2020 04:32:07 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:	SFSU - CHILDREN'S CAMPUS (PRESCHOOL)		FACILITY NUMBER:	384001884
ADMINISTRATOR:	TOBIN-WALLIS, ANNA		FACILITY TYPE:	850
ADDRESS:	N. STATE DR.&LAKE MERCED BLVD.		TELEPHONE:	(415) 405-4011
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94132
CAPACITY:	42	CENSUS: 31	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Allison Guerra		TIME COMPLETED:	04:45 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	Licensing Program Analyst (LPA) Marie Rodriguez conducted an unannounced Annual Random inspection. LPA met with Interim Director Allison Guerra and explained purpose of inspection. The center is a combination center with an infant/toddler program and a preschool program. Both programs operate under a separate license. SFSU - Children's Campus (Infant) has license #384001885. Present in the Preschool center were the Interim Director, 7 staff, and 31 children. Center is operating within capacity requirements and in compliance with child to staff ratio. Hours of operation are Monday to Friday from 7:30am to 5:30pm. LPA inspected preschool rooms Hawk (Room 112) and Owl (Room 114) and their shared outdoor play area with Interim Director. There are no bodies of water, firearms, or weapons on the premises. The center is in good repair with proper temperature and ventilation and is free of any hazards. All furniture is in good condition. Each room has age appropriate toys and equipment. Napping equipment in each classroom is in good condition and is properly stored when not in use. A first aid kit is available in each classroom. All cleaning products and toxins are inaccessible to children. Both preschool classrooms share one large outdoor play area. The outdoor play area is fenced for supervision. The outdoor toys and equipment are age appropriate and in good condition. Play structure is age appropriate and in good repair. There is adequate cushioning underneath the play structure. All required postings and waiver are properly posted in the bulletin board in the hallway. Menu is posted for the whole month. Center provides morning and afternoon snacks. Lunch is provided by parents each day. Each classroom has a kitchen area which is inaccessible to children. Kitchen is clean and free of any toxins or contamination. All food is properly stored to avoid contamination. All storage containers for solid waste have a proper lid. Each classroom has two toilets and sinks. Bathroom areas appear to be clean, in good repair, and free of any hazards. There is a separate bathroom for staff usage on the premises. (Continued on second page)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFSU - CHILDREN'S CAMPUS (PRESCHOOL)	FACILITY NUMBER: 384001884
	VISIT DATE: 01/15/2020

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
26
27
28
29
30
31
32

(Continued from first page)

Last emergency drill was conducted on January 3, 2020. Emergency drills are conducted monthly and are properly logged. Sign-in/out sheets are done electronically in each classroom. The center has a complete electronic record of sign-in/out sheets by authorized pickup person. There is a working fire alarm system throughout the center. A carbon monoxide detector and a fully charged fire extinguisher are in each classroom and a working telephone is available on-site.

Four children records reviewed were complete. All children have a record of emergency identification information on file. Four staff records were reviewed. All staff members have a criminal record clearance on file. Interim Director has a current Pediatric First Aid/CPR certificate which expires August 2021. Multiple other staff also have current Pediatric First Aid/CPR certificates which expire in November 2021.

During inspection,

Interim Director was given information regarding Safe Sleep Practices, Technical Support Program (TSP), Required Lead Testing for Drinking Water in Child Care Centers, and Lead Poisoning Facts Flyer.
Interim Director was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.
Interim Director was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years by all staff hired. Training can be taken online at www.mandatedreporterca.com. If training is not available in native language, a statement can be written stating exemption until the translation is available and filed in staff record..
Interim Director was reminded about the Provider Information Notices (PINs) on CCLD website.
Interim Director was advised for any additional questions to contact CCLD office, Monday to Friday, 8:00 am - 5:00 pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov.

No deficiencies cited today.

This report was reviewed and discussed with Interim Director Allison Guerra. A copy of report was provided.
Notice of site visit was observed being posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2