384002582-1-14-2025-05-CC-ZBAK-DCWN97-20250114091528

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002582
Report Date: 01/13/2025
Date Signed: 01/14/2025 09:15:50 AM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 01/14/2025 09:15 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	KAI MING HEAD START - ST. LUKE CENTER (PS)		FACILITY NUMBER:	384002582
ADMINISTRATOR/ DIRECTOR:	BANDELARIA, EVELYN		FACILITY TYPE:	850
ADDRESS:	1755 CLAY STREET		TELEPHONE:	(415) 690-1014
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94109
CAPACITY: 72	TOTAL ENROLLED CHILDREN: 43	CENSUS: 29	DATE:	01/13/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:17 PM
MET WITH:	Bandi Park		TIME VISIT/ INSPECTION COMPLETED:	03:45 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 January 13, 2024, at approximately 12:00 p.m., Licensing Program Analyst (LPA) Zeynep Basak conducted an unannounced annual inspection, met with the Site Manager, Bandi Park, and explained the purpose of the visit. The facility, located in the basement level of the church, operates Monday to Friday from 8:00 a.m. to 4:30 p.m. Upon entry, the LPA observed 16 staff members, including the site manager, and 29 children present. The facility operates within its capacity and complies with the staff/child ratio on this day. LPA verified staff members’ background clearances on the Guardian website under the Admin File #380505563. LPA inspected four daycare rooms (two preschool and two toddler), children’s bathrooms, the kitchen, and the outdoor play area located on the 3rd floor of the church with the site manager. LPA observed that each classroom has smoke and carbon monoxide detectors and found nine fully charged fire extinguishers (model 2A:10BC) in the entire center. The site manager stated that each classroom conducts emergency drills once a month, and the entire facility conducts an evacuation drill twice a year. The last drill was conducted on 11/14/2024. LPA observed that the facility has age-appropriate furniture, toys, and educational materials in each classroom. The facility floors and rugs are in good condition and free of any hazards. Sleeping cots/mats were observed in each room, and per the site manager, the facility provides sheets and blankets, which are brought from home and sent home weekly to be washed. See page 2.

Daniel J Oquendo	TELEPHONE: (650) 266-8800
Zeynep Basak	TELEPHONE: (650) 266-8800
	DATE: 01/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KAI MING HEAD START - ST. LUKE CENTER (PS)	FACILITY NUMBER: 384002582
	VISIT DATE: 01/13/2025

NARRATIVE

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LPA observed the children’s bathroom. Toilets and sinks were clean, sanitary, and in working condition, and the water temperature was proper. LPA observed that all cleaning solutions and other chemicals were properly stored and made inaccessible to children.
LPA observed the outdoor play area with the site manager and found a variety of play and sports equipment available for the children. All play structures were in good repair, and the playground was free from health and safety hazards.

LPA observed the facility has a fully stocked first aid kit and a functioning telephone. Per the director, there are seven children with allergies at the center at this time. LPA observed the medication box properly stored and containing required forms alongside the EpiPen/medication in the original box, which was up to date. The site manager stated they use the office as an isolation area for ill children to wait for their guardian.

According to Bandi Park, the facility provides breakfast, lunch, and afternoon snacks through the vendor, in addition to drinking water. LPA inspected the kitchen and found it to be clean, sanitary, and free of any food contamination.

Per the site manager, the facility uses an electronic sign-in/out system called “Class Attendance Book,” and LPA observed that all authorized representatives had signed in for the day.
All posting requirements are met by the facility, including the License, Parent’s Rights, and California Child Passenger Safety Law, as observed by the LPA.

LPA reviewed the facility records, nine children’s files, and five staff files. LPA confirmed that all required documents were present in the children’s files, including immunization records (LIC 700) and Personal-Parent Rights forms. LPA also verified that all necessary documents were available in the staff files, including CPR and Mandated Reporter Training certifications.

See page 3.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Zeynep Basak	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KAI MING HEAD START - ST. LUKE CENTER (PS)	FACILITY NUMBER: 384002582
	VISIT DATE: 01/13/2025

NARRATIVE

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The site manager 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Site manager was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

A notice of site visit was given to site manager, Bandi Park and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the site manager, Bandi Park

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Zeynep Basak	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025

LIC809 (FAS) - (06/04)

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