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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002131
Report Date: 07/08/2020
Date Signed: 07/13/2020 10:23:17 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:PRESIDIO KNOLLS SCHOOLFACILITY NUMBER:
384002131
ADMINISTRATOR:CHONGO, GABRIELA S.FACILITY TYPE:
850
ADDRESS:250 10TH STREETTELEPHONE:
(415) 202-0770
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY:180CENSUS: 20DATE:
07/08/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Simona ChangoTIME COMPLETED:
11:30 AM
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On July 8, 2020 Licensing Program Analyst met with site director and conducted an announced case management inspection. The purpose of the inspection was explained and was to approve unlicensed rooms.

Due to Covid-19 Shelter-in-Place, the inspection was conducted via Facetime. Present for the inspection is director and two staff to help measure the rooms. LPA toured four rooms: Rm.9, 10, 11, and 12.

LPA and site director inspected the rooms for health and safety hazards. The classrooms to be used appear to be clean. All furnishings and equipment appears to be safe and in good condition. LPA observed fully charged fire extinguisher, and working carbon monixide and smoke detectors for each room. Rooms each have two exits. Room 9 measures 672 square fee with 3 sinks and 2 toilets; Room 10 measures 843 square fee with 4 sinks and 4 toilets, Room 11 measures 792.67 with 2 sinks and one toilet, and Room 12 measures 863.08 with 2 sinks and one toilet.

The following item must be completed prior licensure:

ยท Fire Clearance approval must be received from SF Fire.

No deficiencies were cited against the facility under CCR, Title 22, Div. 12, Ch. 1.

>This report is emailed to site director who agrees to reply showing receipt of report.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2020
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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