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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002991
Report Date: 05/14/2019
Date Signed: 05/14/2019 11:29:33 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:TINKER PRESCHOOLFACILITY NUMBER:
384002991
ADMINISTRATOR:SLAWSON, DEVONFACILITY TYPE:
850
ADDRESS:554 CLEMENT STREETTELEPHONE:
(415) 299-9821
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:45CENSUS: 43DATE:
05/14/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Miranda Pan, Filippo MontalbanoTIME COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analysts, LPAs Yee, and Van conducted a case management inspection today. There are 43 children and 10 staff members present today. LPAs toured and inspected the facility with site director. One staff member does not have fingerprint clearance. Miranda stated that this staff has been working at the facility for 2 months. A civil penalty of $500 was issued today. This is a repeated violation within the 12 months.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: TINKER PRESCHOOL
FACILITY NUMBER: 384002991
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2019
Section Cited
CCR
101170(e)(1)
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101170(e)(1) Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption as required by the Department.
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Licensee agreed to obtain criminal record clearance for both helpers. Proof to be submitted to the department.
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LPAs observed one staff with no criminal record clearance working at the facility for 2 months. A civil penalty of $500 was issued today. Additional $150 civil penalty was issued for repeated violation

This requirement is not met as evidenced by records review. This poses an immediate safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2019
LIC809 (FAS) - (06/04)
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