384002210-8-31-2022-05-CC-BVAN-CHTV8D-20220831161235

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002210
Report Date: 08/31/2022
Date Signed: 08/31/2022 04:12:47 PM

Document Has Been Signed on 08/31/2022 04:12 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:	PIXIE HALL STUDIOS (PS)		FACILITY NUMBER:	384002210
ADMINISTRATOR:	NELLIE KNOX		FACILITY TYPE:	850
ADDRESS:	649 DIAMOND STREET		TELEPHONE:	(415) 400-4846
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94114
CAPACITY:	10	CENSUS: 0	DATE:	08/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kristin Scagliotti		TIME COMPLETED:	04:15 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	On August 31, 2022, Licensing Program Analyst (LPA) Van met with facility owner Kristin Scagliotti for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the owner. There are no children present today. The Center is still in summer recess and anticipated the opening of the new school year on September 6. The new school year days and operations hours are Monday - Friday from 8:30 am to 2:30 pm. During the inspection, LPA was informed by the owner that the facility has a new Site Director. Gabriela Quiroz will be taking the Site Director role on September 6. LPA reminded the owner to submit the Director qualifications/requirement for Ms. Quiroz to the licensing office. LPA also provided the Director qualifications checklist to the owner. LPA toured and inspected the physical plant for any health and safety hazards. The facility is in good repair and has proper temperature and ventilation. The childcare areas have age-appropriate toys and learning materials. Furniture appears steady and in good repair. The facility has a combination carbon monoxide & smoke detector, working telephones, and a fully charged fire extinguisher. However, the fire extinguisher did not meet the minimum standard of 2A10BC. During the inspection, the owner ordered a new fire extinguisher and showed proof of paid receipt to LPA. LPA observed that each child has their cubbies available. All emergency supplies are stored in locked storage. Medications are appropriately labeled and stored out of reach of children. First aid supplies are fully stocked and available for children's use. All cleaning solutions, poisons, and other dangerous chemicals are stored in an area inaccessible to children. Per the owner, the children are not napping at the Center, as the Center operates only from 8:30 - 2:30 pm. However, the children do have an area for resting and relaxation. Continued on page 2...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

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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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: PIXIE HALL STUDIOS (PS)	FACILITY NUMBER: 384002210
	VISIT DATE: 08/31/2022

NARRATIVE

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The children's bathroom was inspected, toilet and hand-washing sink are in good working condition with proper sanitation. LPA observed no bodies of water on the premises. The facility has granted an outdoor space waiver to use the outdoor playground at 665 Elizabeth Street, San Francisco, CA 94114. The facility shares this outdoor space with St. Phillip the Apostle School and has exclusive use between 11:00 am to 11:30 am.

The facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Per the owner, the Center does not provide food for the children. Foods are brought from home. The children are required to bring their water bottles, and the facility has a water station readily available for children indoors and outdoors. All storage containers for solid waste within the Center have a proper tight-fitting cover.

LPA randomly reviewed children's and personnel records to provide technical assistance and feedback to ensure the Center's record keeping is in incompliance with the regulation. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Multiple staff members have a record of valid CPR. All staff maintained immunization records and had the required ECE units. Per the owner, staff will take the Mandated Reporter Training and Basic Pest management training before the new school year starts on September 6.

The Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

LIC809 (FAS) - (06/04)

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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: PIXIE HALL STUDIOS (PS)	FACILITY NUMBER: 384002210
	VISIT DATE: 08/31/2022

NARRATIVE

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The 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Center owner was informed about Mandated Reporter training. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm

LPA encouraged the Center to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Center staff can also email childcareadvocatesprogram@dss.ca.gov and ask for updates to be added to the email list.

During the inspection, LPA requested the following documents to be sent to Licensing office by Septer 15, 2022.
1. Emergency Disaster Plan (LIC 610)
2. Personnel Report (LIC 500)
3. Designation of Administrative Responsibility (LIC 308)
4. LIC 309 (If applicable)
5. Incidental Medical Services Plan (IMS).
6. New Director, Gabriela Quiroz, Director paperwork.
7. Updated Mandated Reporter Training and Basic Pest Management Training for all staff.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: PIXIE HALL STUDIOS (PS)	FACILITY NUMBER: 384002210
	VISIT DATE: 08/31/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies are cited today. An exit interview was conducted, and the report was reviewed with the Center owner, Kristin Scagliotti. Today's report and notice of site visit were provided to the owner. LPA informed the owner that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

LIC809 (FAS) - (06/04)

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