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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002045
Report Date: 09/13/2021
Date Signed: 09/13/2021 11:36:02 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:LANGUAGE IN ACTION - SFFACILITY NUMBER:
384002045
ADMINISTRATOR:AZUCENA, ADELAFACILITY TYPE:
850
ADDRESS:1 MILEY STREETTELEPHONE:
(415) 310-1335
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94123
CAPACITY:15CENSUS: 13DATE:
09/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Site director Khaterin CastanedaTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Jyoti Saini met with Site Supervisor Khaterin Castaneda for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility. In addition to the Site Supervisor, there are 13 children and 2 staff present today. The facility operates Monday - Friday from 8:00 AM to 5:00 PM. The facility was inspected indoor and outdoor today for health and safety hazards and the following was observed;

The facility has multiple working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available. There are no bodies of water, firearms, or weapons on the premises. The center is in good condition with proper temperature and ventilation and is free of any hazards. All furniture is in good repair. The Center has age-appropriate toys and equipment. A first aid kit is available in the facility. The outdoor play area is fenced for supervision and the resilient material under the play structure is sand. This facility has one toilet and two sinks for children. A separate staff restroom is on the site. Parents provide snacks and lunch for children. There is drinking water readily available for children. The facility has appropriate postings. The last Emergency Drill was conducted on 08/03/2021. LPA reviewed sign-in and out sheet. The center has a complete record of sign-in/out sheets by an authorized pick up person.

LPA reviewed files for children and staff. All children have a record of emergency identification information on file. Three staff records reviewed were complete. The site Director has a current Pediatric First Aid/CPR certificate on file. All staff has taken CPR and Mandated Reporter training.

During inspection,

• Site 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 1597.662.

• Site Director was reminded about Mandated Reporter Training available on the CCLD website. Training must be completed every two years. (Websites: www.ccld.ca.gov or www.mandatedreporterca.com)

• Site Director was reminded about the Provider Information Notices (PINs) on the CCLD website.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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. No deficiencies were cited today.

This report was reviewed and discussed with Site Supervisor Khaterin Castaneda and will be sent to the site supervisor at the email address khaterincastaneda@gmail.com by the close of business on 09/13/2021. Confirmation of receipt is required.

SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2021
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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