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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002983
Report Date: 12/22/2021
Date Signed: 12/22/2021 01:35:32 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:FRANDELJA FAIRFAXFACILITY NUMBER:
384002983
ADMINISTRATOR:COBBINS, CORNELLFACILITY TYPE:
830
ADDRESS:901 B FAIRFAX AVENUETELEPHONE:
(415) 822-1699
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY:21CENSUS: 0DATE:
12/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:34 AM
MET WITH:Cornell CobbinsTIME COMPLETED:
01:50 PM
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Licensing Program Analyst (LPA) Sheran Lo met with director Cornell Cobbins for an annual inspection. Purpose of the inspection was explained. Facility currently has no children enrolled. With Director LPA inspected the infant classroom and play yard. Facility has smoke detector, smoke detector, fully charged fire extinguisher and working telephone at the site. 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. Furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair. Facility has drinking water available for children. Per Director facility provides the snacks and lunch for children. LPA observed cribs in the corner of the classroom. There is drinking water in play yard for children. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is sufficient amount pads under the play structures to prevent any fall injuries.

LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates. 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. LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Cornell Cobbins.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2021
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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