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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002131
Report Date: 07/20/2021
Date Signed: 07/20/2021 01:37:35 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: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: DATE:
07/20/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Gretchen StanersonTIME COMPLETED:
12:25 PM
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On July 20, 2021 at 12:10 PM, Licensing Program Analyst (LPA) Cowan conducted subsequent inspection to clear a deficiency. LPA inspected the facility on July 9, 2021 and found that the water in classroom 5 measured 125 degrees. On this day, LPA observed that water in classroom five measured 109 degrees. LPA cleared deficiency. LPA did not observe any deficiencies during inspection this day.

This report and Plan of Correction letter is emailed to director along with a Notice of Site Visit
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021
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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