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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002514
Report Date: 03/18/2022
Date Signed: 03/18/2022 11:19:20 AM


Document Has Been Signed on 03/18/2022 11:19 AM - 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:SFUSD-COMMODORE STOCKTON EARLY ED SCHOOL (PS)FACILITY NUMBER:
384002514
ADMINISTRATOR:YU, JENNYFACILITY TYPE:
850
ADDRESS:1 TRENTON ST., RMS 1,2,3,&4TELEPHONE:
(415) 291-7932
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94108
CAPACITY:88CENSUS: 75DATE:
03/18/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jenny YuTIME COMPLETED:
11:00 AM
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On March 18, 2022, at approximately 10:00am, Licensing Program Analyst (LPA) Ly conducted an unannounced case management visit at this facility and met with Principal Jenny Yu. The purpose of this visit was explained. LPA and Principal toured the facility for health and safety hazards.

This facility self reported an Unusual Inciden on 03/09/2022. The facility self reported allegations brought against their facility staff. Per Principal, one of allegations involving one of the staff for discriminating against the family for not speaking the same Chinese dialect as the staff has been resolved. The child was new to the facility, child was not able to express for what she wanted and it was misunderstood as child was being ignored.

As for another allegation brought against another staff involved in physical handling of the child is still under investigation by SFUSD. The staff is currently on Administrative Leave. Per Principal Yu, once there's finding to the investigation, licensing will be notified.

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. A copy of this report will be emailed to Principal Jenny Yu. Notice of Site Visit will also be emailed. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2022
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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