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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002584
Report Date: 09/13/2021
Date Signed: 09/13/2021 10:49:05 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:ST. ANNE PRE-KINDERGARTEN (PS)FACILITY NUMBER:
384002584
ADMINISTRATOR:JUDY GLAESER, DIR./APPL.FACILITY TYPE:
850
ADDRESS:1320 14TH AVENUETELEPHONE:
(415) 731-2355
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:28CENSUS: 19DATE:
09/13/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Judy GlaeserTIME COMPLETED:
11:00 AM
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On September 13, 2021 at approximately 9:45am, Licensing Program Analyst (LPA) Winnie Ly met with Program Director Judy Glaeser for an announced prelicensing inspection for an increase in capacity. Present in the facility were Program Director and 2 staff caring for 19 preschool children.

Facility has a current capacity of 28 children; the facility is requesting an increase to 52 children. This facility operates in 2 classrooms (Room name are Pre-K and Junior Pre-K) on the functioning school site at St. Anne School. An approved Fire Clearance was granted for a total capacity of 52 on 09/07/21.

On this day, LPA measured the classroom the facility is requesting the increase in capacity for Classroom Junior Pre-K. Classroom Junior Pre-K indoor space measures at 951.52 square feet, allowing for 27 children. Bathroom has 2 toilets and 1 sink. Classroom has an additional sink. Facility has enough indoor space for the requested additional capacity of 24 children.

Prior to Licensure:
** Classroom needs to be fully set up/furnished.
** Facility needs to have outdoor waiver with new capacity number requested.
** Follow up Visit will be Conducted.

An Exit Interview was conducted with Licensee. No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. A copy of this report and appeal rights were discussed and left with Licensee whose signature on this form confirm receipt of these reports. Notice of Site Visit was posted. 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: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2021
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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