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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002040
Report Date: 09/06/2022
Date Signed: 09/06/2022 01:01:29 PM


Document Has Been Signed on 09/06/2022 01:01 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:ST.THOMAS THE APOSTLE PRE&K LRNG CTRFACILITY NUMBER:
384002040
ADMINISTRATOR:MEN, JIA JUNFACILITY TYPE:
850
ADDRESS:710 - 40TH AVENUETELEPHONE:
(415) 387-5511
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:75CENSUS: 42DATE:
09/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Jia Jun Men (Jessie)TIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the Site Director, Jia Jun Men (Jessie). The purpose of the inspection was explained to her. There were 42 children with 10 staff present. All adults had fingerprint clearance. The facility was located at the St. Thomas The Apostle Church. The church had Elementary and Preschool programs. The entrance of the preschool was on 40th Avenue. The operation hours of the facility were Monday to Friday from 8 AM to 6 PM. The facility has run the preschool program in 4 classrooms (Blue class, Yellow class, Older 3 years old, and Pre-K). The facility divided a big classroom into 2 separate classrooms with the panels. LPA toured and inspected 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 made inaccessible to the children. All electrical outlets were covered. The sharp corners were covered, Right amount of cubbies were available for the children to store own belongings. There were plenty of age-appropriate toys, books, learning material, and children's furniture that were in good condition and repairs available for children. Children's bathroom had two toilets, three urinals and 2 big sink with 4 faucets and 1 regular sink with a faucet. The children's bathroom was clean and free of harmful objects. Separated staff bathroom was available for staffs. Children bring their own lunch and the facility provided snacks only for children. The children have brought their own water bottles to school as well. Parents have had an option to order the Elementary School lunch for their children and delivered to the center during the regular semester as well. First aid supplies were available for children in each classroom at the center. Sick children will be separated from the group and place in the Director's office while waiting for their parents to pick up. Cots were used as the napping equipment. Facility has its own outdoor play area in the back of the property. The outdoor play yard was completely fenced and separated from the Elementary school with fence. There were plenty of age-appropriate outdoor toys, sand box with shade, play structure with soft cushioning underneath, play houses, and children's furniture that were in good condition and in repairs available for the children. At least one staff on site has current CPR and First Aid training. It will expire in 9/2023. Per Site director, there was a child on special medication. LPA inspected the storage of medication and documents. The facility had all required postings. LPA reviewed the staff and children files during the inspection. LPA also obtained a copy of the children's roster from the facility during the inspection. Staff had current Child Abuse Mandated Reporter Training (AB1207). The facility has done the emergency drill monthly and logged. LPA inspected the sign in/out sheet.

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: 09/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2022
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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