384002978-10-11-2019-05-CC-WWIR-BGUND5-20191011102147

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002978
Report Date: 10/11/2019
Date Signed: 10/11/2019 10:22:10 AM

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:	PETITE EXPLORER PRESCHOOL		FACILITY NUMBER:	384002978
ADMINISTRATOR:	LAM, VICTORIA		FACILITY TYPE:	850
ADDRESS:	722 SOUTH VAN NESS		TELEPHONE:	(415) 872-9185
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	66	CENSUS: 34	DATE:	10/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Andy Wong		TIME COMPLETED:	11:00 AM

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	An annual comprehensive random inspection was conducted today. Licensing Program Analysts (LPA) Wendi Wittmeyer and Farhan Bashir-Tariq met with Director Andy Wong and explained the purpose of the inspection. The facility building and grounds were inspected, and children and staff records were reviewed. Staff records during today’s visit indicate that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances multiple staff have current first aid and mandated reporter certifications. . . A review of staff records during today’s visit indicates individuals at this facility who require caregiver background checks are issued by the County Office of Education and do not come under the jurisdiction of Community Care Licensing. Days and hours of operation are: Monday -Friday 8-6PM The following was observed today: Waivers for playground rotation and electronic sign in and out.. Current facility directors are Andy Wong Victoria Lam Current rooms used for care: Discover Room, Explorer room, Petite and the Wonder Room. The following items were reviewed as part of today's visit: Care and Supervision of the Children this facility was in ratio today with 34 children and 9 staff, Child Discipline Procedures this facility uses redirection and communication, Emergency Evacuation Procedures (smoke and carbon monoxide detectors present and in working order), Medication Policies every classroom has emergency backpack with first aid supplies, Isolation of Sick Children is done in the directors office until parents can pick them up, Napping Requirements children bring in own bedding which they launder weekly staff disinfects mats after each use, Food Service this facility provides snacks morning and afternoon, parents send in lunch. Posting requirements for site visits were also discussed as well as AB 633 requirements. continuation on next page...

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Wendi Wittmeyer	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019

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: PETITE EXPLORER PRESCHOOL	FACILITY NUMBER: 384002978
	VISIT DATE: 10/11/2019

NARRATIVE

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Current forms and Title requirements for site visits were also discussed as well as AB 633 requirements. Current forms and Title 22 Regulations can be obtained through the internet at www.ccld.ca.gov. Staff immunization are on file.
Director was reminded 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. Influenza Declarations were also reviewed
Director was advised of Pesticides training. For More information about changes to the Healthy Schools Act, templates, articles, and required training you can inspect the DPR website at: https://apps.cdpr.ca.gov/schoolipm/childcare/training/
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

No deficiencies cited today.

"NOTICE OF SITE VISIT" DOCUMENT WAS POSTED ADJACENT TO THE MAIN ENTRY DOORWAY AND VISIBLE TO PARENTS. LICENSEE MUST POST ANY TYPE A DEFICIENCIES DURING TODAYS VISIT WITH THE NOTICE AND LICENSEE UNDERSTANDS THE NOTICE AND TYPE A DEFICIENCIES MUST REMAIN POSTED FOR THIRTY DAYS. REQUIREMENTS FOR AB 633 FACT SHEET AND A COPY OF ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) WERE DISCUSSED WITH APPLICANT/PROVIDER. PROVIDER UNDERSTANDS THIS REQUIREMENT.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Wendi Wittmeyer	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019

LIC809 (FAS) - (06/04)

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