384002757-4-23-2024-05-CC-LGOZ-D4LS5N-20240423133436

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002757
Report Date: 04/23/2024
Date Signed: 04/23/2024 01:35:30 PM

Document Has Been Signed on 04/23/2024 01:35 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SF TIKES ACADEMY		FACILITY NUMBER:	384002757
ADMINISTRATOR:	SHIMKUNAS, SARAH		FACILITY TYPE:	850
ADDRESS:	1218 SOUTH VAN NESS AVENUE		TELEPHONE:	(415) 826-8222
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	117	CENSUS: 58	DATE:	04/23/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Sarah Shimkunas, Kristina Itskovich		TIME COMPLETED:	01:40 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	On 4/23/2024 at 8:45AM., Licensing Program Analyst (LPA), Luis Gomez met with Director, Sarah Shimkunas. The purpose of today's inspection was explained and was for an Unannounced, Annual Random inspection. Facility is licensed to operate a preschool program with toddler component. Present was the director and 10 staff supervising 58 children. All children had been properly signed in. Staff have criminal record clearances on file. The childcare program utilizes five classrooms: Koala, 4–5 year olds; Fish, 2-3 year olds; Grasshopper /Toddler Classroom, 18- 36 months; Flamingo, 2- 3 year olds; Elephant, 4 year olds, and the shared, Multi-Purpose Room and Outdoor Play Area. Outdoor space waiver and schedule was observed posted in facility. Per director, the cat classroom is not in operation. Licensee, Kristina Itskovich arrived during inspection. LPA inspected this facility for health and safety hazards. At 9:00AM., LPA observed the following: Classrooms were clean, orderly, with age-appropriate materials available for the children. The floor and ground surfaces were clear of obstructions or possible hazards. Each classroom was equipped with tables and chairs, scaled to the proper size, and individual cubbies for belongings. Accessible furniture was free of any sharp corners or splinters. The children’s bathrooms were maintained clean, with fixtures in operating condition. Classroom was equipped with added cabinets for storage of supplies. Diaper changing tables, located within arm’s reach of a sink, was available for staff. Per director, area is disinfected after each use. LPA observed trash bins equipped with tight-fitting lids. For scheduled rest/ nap, LPA observed cots, made from a cleanable material. Per director, napping sheets and blankets are washed weekly by families. The facility had adequate ventilation, lighting, and was a comfortable temperature. Facility had a functioning telephone service, carbon monoxide detector (Built-in), and fully changed fire extinguishers: 2A:10BC. Facility’s detergents, cleaning compounds, medications, and other items which could pose a danger, had been stored inaccessible to children. (REFER TO 809c, FOR CONT.)

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SF TIKES ACADEMY	FACILITY NUMBER: 384002757
	VISIT DATE: 04/23/2024

NARRATIVE

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At 10:00AM, LPA reviewed the outdoor play area. Area was enclosed with rubber padding installed for added safety. LPA observed accessible shaded and refillable water bottles, available for children for to drink as they wish.

The food preparation/ storage was reviewed during inspection. The program provides two snacks, which include a morning and afternoon. The food preparation area was observed clean, free of trash or rubbish. Food containers inspected were current.

At 10:40AM., LPA reviewed facility records including: 5 children’s files and 10 personnel files. The personnel files were reviewed and contained: Teachers Qualifications; Notice of Employee Rights (LIC9052); Acknowledgement to Report Suspected Child Abuse (LIC9108); and Personnel Record.

LPA reminded director to ensure staff renew their 'Mandated Reporting Training' course (AB1207). Certificated must be stored in personnel records.

Facility’s children’s files were reviewed and contained the: Identification and Emergency Information (LIC700); Notification of Parent’s Rights (LIC995); Consent for Emergency Medical Treatment (LIC627); Immunization Records; and Personal Rights (LIC613A).

Staff is maintaining required infant napping logs for children in toddler classroom.

Director's Cardiopulmonary Resuscitation / First Aid certifications, was current, and expire on: 7/2026.

Facility is conducted required emergency disaster drills every six months, with last drill completed on 3/22/2024.

LPA observed required postings including the: Facility License; Notification of Parent’s Rights (PUB394); Passenger Safety Laws (PUB269); Outdoor Space Waiver; Toddler Play Schedule; Snack Menu; Earthquake Preparedness Checklist (LIC9148); and Emergency Disaster Plan (LIC610).

Assembly Bill (AB) 2370, chapter 676, statues 2018 requires all licensed child care centers (CCC’s) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and every five years after the date of the first test.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN21-21- CCP. (REFER TO 809c, FOR CONT.)

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SF TIKES ACADEMY	FACILITY NUMBER: 384002757
	VISIT DATE: 04/23/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, no deficiencies were cited in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations. Exit interview, including the facility evaluation report was discussed with Director, Sarah Shimkunas. Administrator’s signature on this form acknowledges receipt of these documents.

This report must be made available in facility for public review. Notice of site visit was given and must remain posted for 30 days. Director was advised, any additional questions/ concerns to contact the office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

LIC809 (FAS) - (06/04)

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