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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002753
Report Date: 09/01/2021
Date Signed: 09/01/2021 03:56:40 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:K.E.E.P.-SFPMFACILITY NUMBER:
384002753
ADMINISTRATOR:BLY, JOSEPHFACILITY TYPE:
840
ADDRESS:2340 JACKSON STREETTELEPHONE:
(415) 749-3544
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY:75CENSUS: 48DATE:
09/01/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Anna VigilTIME COMPLETED:
04:25 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with director for this required annual licensing visit. Purpose of visit explained. Facility operates their school aged program on the SFUSD - PUBLIC MONTESSORI SCHOOL campus. There are 48 children present during the visit. Facility meets teacher/child ratio today. Days and hours of operation: Monday, Tuesday, Thursday, Friday 2:50-6:00PM and on Wednesdays 1:40PM-6:00PM. The facility has fully charged fire extinguisher that meet the minimum requirements, smoke detectors, and carbon monoxide (CO) detectors in facility. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per director, there are no firearms or weapons on site. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Variety of age appropriate toys and materials for children is available. Classrooms are set up for child care and furniture and equipment for children is present. Facility provides one afternoon snack. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. Outdoor play area inspected for health and safety hazards. The areas outside are play structures is cushioned with soft rubber. Outdoor activity space surfaces are free of hazards. Facility has posted all the required licensing forms in a prominent accessible locations. LPA reviewed staff and children's files. LPA reviewed staff and children's files. In the children's files that were reviewed, each child had a complete record maintained. In the staff files reviewed, staff have verification the required immunizations: measels (MMR), pertussis (Tdap), and optional flu shot notification. Staff need to update their Mandated Child Abuse training (AB1207); director needs to update Pediatric First Aid and CPR. Director given a checklist to send in the change in director packet for her self.

This report is reviewed with director and a copy of this report must be made available for public review upon request.

Notice of site visit posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
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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