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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384003012
Report Date: 08/17/2023
Date Signed: 08/17/2023 03:34:51 PM


Document Has Been Signed on 08/17/2023 03:34 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:SUNSHINE PRESCHOOL CENTERFACILITY NUMBER:
384003012
ADMINISTRATOR:YUZON, NADINEFACILITY TYPE:
850
ADDRESS:650 ANDOVER STREETTELEPHONE:
(650) 291-0512
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:30CENSUS: 5DATE:
08/17/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Nancy Azar TIME COMPLETED:
03:35 PM
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On 8/17/2023 at 2:10PM., Licensing Program Analyst (LPA), Luis J. Gomez met with Licensee, Nancy Azar. Purpose of the inspection was explained and was for an Unannounced; Plan of Correction inspection. Present was the director, licensee, and 1 staff, supervising 5 children. Per licensee, two children present are enrolled in toddler component. LPA inspected facility for health and safety hazards.

During today’s inspection, LPA performed record review, observations, and interviews.

At 2:20PM., During inspection, LPA observed toddler option and preschool-age cohorts both have a qualified teacher present. Per director, there is no co-mingling between the programs. Updated toddler option schedule was observed posted during inspection.

At 2:35PM., LPA reviewed facility record, included the staff and children's files.

LPA reminded licensee to ensure children files contain the: Consent for Emergency Medical Treatment (LIC627); Identification and Emergency Information (LIC700); Personal Rights (LIC613A); and Notification of Parent’s Rights (LIC995). Advisory Note: Technical Violation (LIC9102TV) was issued during inspection.

Deficiencies issued on 6/15/2023, 7/6/2023, have been cleared and ‘Cleared Plan of Correction Letters’ were provided.

**No deficiencies were cited against the facility today under CCR, Title 22, Div. 12, Chapter. 1**

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Licensee was advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023
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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