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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002365
Report Date: 07/16/2019
Date Signed: 07/16/2019 09:34:15 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:FLORES, ANDREA & TORRES, ARTUROFACILITY NUMBER:
384002365
ADMINISTRATOR:FLORES, ANDREA & TORRES, AFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 742-4526
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 10DATE:
07/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Andrea Flores, Haydee FloresTIME COMPLETED:
09:45 AM
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1, Licensing Program Analyst, LPA Yee conducted an annual random inspection today. the purpose of the inspection was explained. There are 10 children, licensee, Andrea, and 3 helpers present today. Current residents are Andrea, her husband and her father in law. Facility personnel summary report was reviewed with Andrea and she said it's current. Daycare areas: living room, dining room, bathroom, bedroom #1 and back yard. The remaining areas of the home are off-limit. The home is equipped with the fire extinguisher, carbon monoxide detector, and smoke detector. Emergency drills are conducted monthly. All required immunization for staffs is on file. Licensee and staff have current CPR/1st aid certificate which expires 3/2021. Children roster was reviewed. LPA discussed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/ All staff AB1207 certificate on file. This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies and reviewed children's, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 102417. 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. Licensee will submit a written IMS plan within 2 weeks. SIDS " A Child Care Provider's Guide to Safe Sleep" was provided
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
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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