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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002983
Report Date: 10/24/2022
Date Signed: 10/24/2022 02:27:14 PM


Document Has Been Signed on 10/24/2022 02:27 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: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: 6DATE:
10/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:08 PM
MET WITH:Vernee Pulliam-DavisTIME COMPLETED:
02:24 PM
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On October 24, 2022, Licensing Program Analysts (LPA) Sheran Lo met with Lead Teacher Vernee Pulliam-Davis for an annual inspection. Purpose of the inspection was explained. Present in the facility are 3 teachers and 6 children in care. Facility is operating within its capacity and is in compliance with staff / child ratio on this day. Facility operates childcare from Monday - Friday 8:00AM to 5:0PM.

With Director, LPA inspected the childcare room and play yard. LPA observed facility has smoke detector, carbon monoxide detector, fully charged fire extinguisher and working telephone on site. All cleaning solutions, poisons, and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Facility floor is in good repair and free of any hazards.

There are first aid supplies available in the classrooms. All bathrooms are in working condition. All storage containers for solid waste are in good repair. All food is stored properly to avoid contamination. Facility has a sufficient amount of sleeping mats available and provides sheet/blankets laundered on site. Individual items provided by the parents are labeled and stored appropriately. Two snacks are prepared at facility, lunch is catered by Chefables, and food preparation area is free of litter. Food is stored adequately to prevent contamination. Facility has outdoor space for each age group.. There is water available for children in the outdoor as well as in the classroom.

LPA observed that facility is using electronic sign in / out. LPA collected a print-out of sign in/out. Facility has license and all other required documents posted and visible for the public. There are menus posted at least one week in advance and are visible to the child's authorized representative. Facility has an emergency drill log for the school year. LPA reviewed the facility records. LPA reviewed 5 random children's files and 3 random staff's files.

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2022
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: FRANDELJA FAIRFAX
FACILITY NUMBER: 384002983
VISIT DATE: 10/24/2022
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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.

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/inspection-process.

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-sleephttps://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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Lead Teacher Vernee Pulliam-Davis.

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022
LIC809 (FAS) - (06/04)
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