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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002754
Report Date: 09/23/2022
Date Signed: 09/23/2022 02:24:36 PM


Document Has Been Signed on 09/23/2022 02:24 PM - It Cannot Be Edited

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:TINY KNIGHTS PRESCHOOL AT SAINT GABRIEL SCHOOLFACILITY NUMBER:
384002754
ADMINISTRATOR:MORAN, KIMBERLYFACILITY TYPE:
850
ADDRESS:2550 - 41ST AVENUETELEPHONE:
(415) 566-0314
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY:30CENSUS: 24DATE:
09/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Kimberly MoranTIME COMPLETED:
02:30 PM
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On September 23, 2022, Licensing Program Analyst (LPA) Van met with Director Kimberly Moran for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the Director. Present today are 24 children supervised by 5 teachers. The facility complies with the staff-children ratios today. All staff members have criminal record clearances on file. The Center operates in a large classroom in the San Gabriel School Site. The days and operations hours are Monday - Friday from 7:30 am to 5:30 pm.

LPA toured and inspected the physical plant for any health and safety hazards. The facility has a record of sign-in/out of children. All parents' signatures matched and accounted for the number of children present. The facility is in good repair and has proper temperature and ventilation. The classroom is partitioned into two p, and each pod has age-appropriate toys and learning materials. Furniture appears steady and in good repair. The facility has multiple carbon monoxide detectors, a centralized smoke alarm, fully charged fire extinguishers, and working telephones. LPA observed that each child has their cubbies available with their name labeled. All emergency supplies are stored in locked storage. Medications are appropriately labeled and stored out of reach of children. First aid supplies are fully stocked and available for children's usage. All cleaning solutions, poisons, and other dangerous chemicals are stored in an area inaccessible to children. Sleeping cots are appropriately stored.

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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2022
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: TINY KNIGHTS PRESCHOOL AT SAINT GABRIEL SCHOOL
FACILITY NUMBER: 384002754
VISIT DATE: 09/23/2022
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The Center has two toilets and two sinks for children, and the staff has a separate bathroom. All toilets and handwashing sinks are in good working condition with proper sanitation. LPA observed no bodies of water on the premises. The facility currently has an outdoor waiver approved to allow 22 children to play outdoors each time. The outdoor play area is completely fenced, clean, and in good repair. Outdoor toys are age-appropriate, in good condition, and free of loose parts.

The facility had posted the required forms. (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Per the Director, the Center does not provide food for the children. The daily schedule is observed posted. The facility has water fountains readily available for children indoors and outdoors. All storage containers for solid waste within the Center have a proper tight-fitting cover.

Ten random children's records and personnel records were reviewed during the inspection. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Staff records indicate that all staff or other individuals who require caregiver background checks have received criminal records and child abuse index clearances or exemptions. all staff members have a record of valid CPR and maintain proper immunization records. LPA reviewed the educational qualification of the Director and staff, and all staff had the required ECE units. The Director stated that the Center conducts fire and earthquakes monthly, and the last drill was conducted on August 25, 2022.



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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
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: TINY KNIGHTS PRESCHOOL AT SAINT GABRIEL SCHOOL
FACILITY NUMBER: 384002754
VISIT DATE: 09/23/2022
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative records. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

The Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The Director was informed about Mandated Reporter training. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPA encouraged the Director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.



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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
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: TINY KNIGHTS PRESCHOOL AT SAINT GABRIEL SCHOOL
FACILITY NUMBER: 384002754
VISIT DATE: 09/23/2022
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During the inspection, LPA requested the following documents to be sent to Licensing office by September 30, 2022; Emergency Disaster Plan (LIC 610), Personnel Report (LIC 500), the Designation of Administrative Responsibility (LIC 308), Incidental Medical Services Plan (IMS), and updated Mandated Reporter training and Basic Pest Management Training.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies are cited today. An exit interview was conducted, and the report was reviewed with the Director, Kimberly Moran. Today's report, September 23, 2022, and notice of site visit were provided to the Director. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
LIC809 (FAS) - (06/04)
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