384002530-8-21-2019-05-CC-GSIH-BF9R2P-20190821123839

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002530
Report Date: 08/21/2019
Date Signed: 08/21/2019 12:38:45 PM

COMPREHENSIVE INSPECTION

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:	WU YEE CHILDREN'S SERVICES - KIRKWOOD CCC (INF)		FACILITY NUMBER:	384002530
ADMINISTRATOR:	TAYLOR, RAVELLE		FACILITY TYPE:	830
ADDRESS:	729 KIRKWOOD AVENUE		TELEPHONE:	(415) 822-5505
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94124
CAPACITY:	22	CENSUS: 20	DATE:	08/21/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Ravelle Taylor		TIME COMPLETED:	10:45 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) Singh met with director, Ravelle Taylor, for a random annual inspection. Purpose of the inspection was explained. Present, there are 20 children in care. Facility is operating with in the capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday between 8 AM to 4:30 PM. With director, LPA inspected the day care rooms and play yard. LPA observed facility has smoke detector, 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. Furniture has round corners, with any sharp corner. Facility has sufficient amount of cribs and sleeping matts available. Facility is floor is in good repair and free of any hazards. There is first aid supplies available in the classroom. All 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 lid on top. All the food is stored in properly manner and has lid to avoid any contamination. Bottles and other items provided by the parents are labeled and stored appropriately. Food preparation area is free of litter. All of the food is stored adequately to prevent any contamination. Play yard is free of hazards. There is sufficient amount of cushion material in the play yard to prevent any fall injuries. At 10:15 AM, LPA reviewed the facility records. LPA observed that facility is using electronic sign in / out and has waiver posted. Facility has license and all of the other required documents posted and visible for the public. LPA reviewed five random children's and five random staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child’s record has record of immunization. Multiple staff members has record of valid CPR card in file. Facility staff has record of their required immunization on file. There are menus posted at least one week in advance and are visible to the child's authorized representative. See next page for continuation .........

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

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: WU YEE CHILDREN'S SERVICES - KIRKWOOD CCC (INF)	FACILITY NUMBER: 384002530
	VISIT DATE: 08/21/2019

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Continuation from previous page .............

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

LIC809 (FAS) - (06/04)

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