384002445-9-4-2019-05-CC-FBTQ-BFPP6C-20190904110207

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002445
Report Date: 09/04/2019
Date Signed: 09/04/2019 11:02:34 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:	GAN NOE PRESCHOOL		FACILITY NUMBER:	384002445
ADMINISTRATOR:	POTASH, LEAH		FACILITY TYPE:	850
ADDRESS:	3781 CESAR CHAVEZ STREET		TELEPHONE:	(415) 648-8000
CITY:	SAN FRNCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	30	CENSUS: 22	DATE:	09/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Leah Potash		TIME COMPLETED:	11:45 AM

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	Licensing Program Analyst (LPA) Farhan Bashir-Tariq met with Director, Leah Potash, to conduct an Annual Inspection on 9/04/19. Purpose of the inspection was explained. Present, there were 22 children in care with 3 teachers and the Director. Facility is operating within the capacity and is following staff child ratio on this day. Facility operates day care from Monday to Friday between 8:00 AM to 5 PM. Facility provides Lunch and two snacks . LPA inspected the day care areas with the Director. Per Director, there are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, a carbon monoxide detector, fully charged fire extinguisher and working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper tight-fitted lid on top. Facility has drinking water available for children. All the materials and surface accessible to the children is clean. LPA reviewed the facility records. LPA reviewed 8 random children's and 3 staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's record contains the record immunization. Multiple staff members have record of valid CPR card in file. Facility has a log for emergency drills being conducted. Per log, last emergency drill was conducted on May 30, 2019. Continuation on next page...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

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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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: GAN NOE PRESCHOOL	FACILITY NUMBER: 384002445
	VISIT DATE: 09/04/2019

NARRATIVE

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LPA reminded the facility that All adults, 18 years and older living in the home, helper, or assistant must have finger print clearance and must be associated to the facility by submitting an LIC 9182 with a copy of CDL or CA. ID prior to having any contact with children in care failure to do so could result in an immediate civil penalty.

LPA reminded the facility that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA observed the records of immunization for Director and Staff present today.

LPA reminded the facility, As of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the training completion certificates for the Director.

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

>No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit. Licensee was advised for any additional questions to call Office, M-F, 8AM-5PM at 650-266-8800 . For Rules and Regulations, visit the Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

LIC809 (FAS) - (06/04)

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