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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002677
Report Date: 11/19/2019
Date Signed: 11/19/2019 02:05:59 PM

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:TEACHING TOTS PRESCHOOL, INC.FACILITY NUMBER:
384002677
ADMINISTRATOR:ARSENIO, M. & ZHANG, X.FACILITY TYPE:
850
ADDRESS:939 IRVING STREETTELEPHONE:
(415) 731-9705
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:30CENSUS: 25DATE:
11/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Melinda ArsenioTIME COMPLETED:
02:20 PM
NARRATIVE
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On November 19, 2019, at approximately 11:30am Licensing Program Analyst (LPA) Winnie Ly conducted an unannounced annual visit at and met with Site Director, Melinda Arsenio during the visit. Purpose of the inspection was explained. There are 25 children staff members. Teacher to child ratios were met on this day. The facility has fully charged fire extinguisher that meet the minimum requirements, smoke detectors, and a carbon monoxide detector were observed. The facility operates Monday - Friday from 7:00 AM to 6:00 PM. The center uses an a clip board for parents to sign their children in and out of the school.

At approximately 11:50am, LPA reviewed sign in and sign out sheet and found only 18 children were signed in while there were 25 children present at the facility today. LPA also observed some parents' signatures are represented with initials or signed in as "MOM." LPA informed Site Director all parents must sign their children in and out of the school with full signature. This poses a potential health and safety risk for children in care. Type B violation issued today.

LPA and Site Director inspected the center for Health and Safety Hazards. There are no pools, spas or other bodies of water on the premises. Per the Site Director, there are no firearms or weapons in the center. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. All cleaning supplies and other potentially harmful items are stored inaccessible to the children. LPA reviewed medication procedures with staff. If there was an ill child, staff would separate the child from the group while waiting for a parent to pick them up. Furniture and equipment are in good condition, free from loose, sharp or pointed parts. Children's bathrooms are in working order with adequate supplies. There are separate bathrooms on site for adults. The food prep area is clean and orderly. The center provides morning and afternoon snacks for children in care. Menus are posted in the center. All solid waste storage containers have tight fitting lids. Drinking water is provided indoor and outdoor by water bottles children brought from home.

CONTINUED>>>
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 5
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: TEACHING TOTS PRESCHOOL, INC.
FACILITY NUMBER: 384002677
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/07/2019
Section Cited

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(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. This requirement was not met evidenced by:
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Based on LPA reviewed of staff record, 2 staff member did not have Licensing forms on file such as LIC 501, LIC 503.
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A follow up visit will conducted to verify correction.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 11/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: TEACHING TOTS PRESCHOOL, INC.
FACILITY NUMBER: 384002677
VISIT DATE: 11/19/2019
NARRATIVE
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LPA and Site Director also toured the outdoor play area for Health and Safety Hazards. LPA observed outdoor equipment is in good condition, free from loose, sharp or pointed parts. The play structure appears to be age appropriate for children in care. Areas under slides and other climbing equipment is adequately cushioned with sand. Last Emergency Drill was conducted on 08/22/2019 and properly logged. At least one staff have current Pediatric First Aid and CPR. Facility has posted all the required licensing forms in a prominent visible location.

At approximately 1:00PM, LPA reviewed children's record and found 3 children's record were incomplete. These 3 files only had immunization record. Per Director, she had given paperwork to the parents but parents either lose it or forgot to turn in. LPA informed Site Director all children must have a complete record before enrollment date. This poses a potential health and safety risk to the children in care. Type B violation issued today.

At approximately 1:45PM, LPA reviewed staff files and found 2 assistants' records were incomplete. LPA informed Director of the missing documents. This posses a potential health and safety risk to children in care. Type B violation issued today.

Facility does not have IMS on file at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA advised facility Director to have an IMS plan and send to LPA.

CONTINUED>>>
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: TEACHING TOTS PRESCHOOL, INC.
FACILITY NUMBER: 384002677
VISIT DATE: 11/19/2019
NARRATIVE
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Facility was also informed 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. All staff have proof of Immunization.

LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Director was also advised to reach out to San Bruno Regional Office for concern or questions. Desk Duty is available M-F, 8a.m.-5p.m. (650) 266-8800. Website for forms and regulations updates: www.cdss.cs.gov/inforesources/Community-Care-Licensing

The following deficiencies were being cited based on LPA Winnie Ly’s observation in accordance with the California Code of Regulations, Title 22, see LIC 809D.

An exit interview was conducted and Plans of Corrections (POC) were developed and reviewed with Licensee. A copy of this report and appeal rights were discussed and left with Site Director whose signature on this form confirm receipt of these reports.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: TEACHING TOTS PRESCHOOL, INC.
FACILITY NUMBER: 384002677
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/06/2019
Section Cited

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101229.1(a)(1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day. This requirement was not met evidenced by:
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Based on LPA reviewed the center's sign in/out log, there were 25 children present but only 18 signatures shown on sign in log. This poses a potential health and safety risk to children in care.
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A follow up visit will conducted to verify correction.
Type B
12/06/2019
Section Cited

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Child's Records – (a) A separate, complete and current record for each child is maintained in the child care center. This requirement was not met evidenced by:
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Based on LPA reviewed of children's record, 3 children enrolled only had immunization record on file. This poses a potential health and safety risk to children in care.
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A follow up visit will conducted to verify correction.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 11/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5