384002727-7-30-2021-05-CC-FBTQ-C5F5VA-20210730201713

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002727
Report Date: 07/30/2021
Date Signed: 07/30/2021 08:17:36 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:	MARTIN LUTHER KING JR. CENTER		FACILITY NUMBER:	384002727
ADMINISTRATOR:	COLLIER, ANDERA		FACILITY TYPE:	850
ADDRESS:	200 CASHMERE STREET		TELEPHONE:	(415) 401-1377
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94124
CAPACITY:	38	CENSUS: 20	DATE:	07/30/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Andrea Collier		TIME COMPLETED:	04:00 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	* This report was prepared in CCLD Regional Office ,San Bruno due to COVID-19 restrictions. Facility inspection was conducted on 7/30/21. Andrea was informed that a copy of this report will be emailed to her by next day on 7/31/21 * Licensing Program Analyst (LPA), Farhan Bashir-Tariq arrived at the facility above unannounced and met with site supervisor, Andrea Collier to conduct a required one-year inspection. Purpose of inspection was explained. Present, there were 20 children in care with 7 teachers. Facility is operating within the capacity and is following staff child ratio on this day. Facility operates day care from Monday to Friday between 7:30 AM to 5:30 PM. Facility is a part of food program and provides breakfast, lunch and two snacks. Risk assessment was completed with Andrea to identify any COVID risks. No risks were identified. LPA and Andrea inspected the day care area for health and safety hazards. There are no pools, spas or other bodies of water available at the facility. Facility has multiple smoke detectors, carbon monoxide detectors and fully charged fire extinguishers of size 2A10BC or bigger. A working telephone was available at the facility. 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, books, arts and other learning materials available for children in classrooms. Furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. Bathrooms were located in each classroom. All toilets, hand washing facilities are in working condition with proper sanitation in place. Facility has drinking water available for children. All the materials and surface accessible to the children is clean and toxic free. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. Soft cushioning was observed under the play structures to prevent any fall or injuries. Cubbies were available for children to store their belongings in each classroom. Menu were observed to be posted in each classroom along with the daily activity schedule.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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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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: MARTIN LUTHER KING JR. CENTER	FACILITY NUMBER: 384002727
	VISIT DATE: 07/30/2021

NARRATIVE

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LPA reviewed facility records. LPA reviewed 5 random children's and 4 staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's record contains the record of immunization. All Posting requirements were met. Posters for COVID-19 symptoms, social distancing and other important information were observed to be posted. Masks, sanitizers and cleaning wipes were available in the facility. LPA reminded the facility, As of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encouraged the facility to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates

Ø No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

This report and rights to comment and appeal were discussed with Andrea. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from the date of visit. Facility was advised for any additional questions to call office, M-F, 8AM-5PM at 650-266-8800 . For Rules and Regulations, visit the Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

LIC809 (FAS) - (06/04)

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