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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384003091
Report Date: 07/30/2021
Date Signed: 07/30/2021 02:05:53 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:SFUSD-TULE ELK PARK AT MARINA EARLY EDUCATIONFACILITY NUMBER:
384003091
ADMINISTRATOR:KATHLENE DOMINGUEZFACILITY TYPE:
850
ADDRESS:1950 CHESTNUT STREETTELEPHONE:
(415) 749-3551
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94123
CAPACITY:96CENSUS: 7DATE:
07/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Mandy Rice TIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA), Farhan Bashir-Tariq arrived at the facility above unannounced and met with Admin Staff, Mandy Rice and Tecaher, Leonida Avenis to conduct a required one-year inspection. Purpose of inspection was explained. Present, there were seven children in care with three teachers. Facility is operating within the capacity and is following staff child ratio on this day. This preschool program runs at the school site. Facility operates day care from Monday to Friday between 7:00 AM to 6:00 PM. Facility is a part of food program and provides breakfast, lunch and two snacks. Risk assessment was completed with Mandy to identify any COVID risks. No risks were identified. Facility is currently running their summer program.

LPA and Mandy inspected the day are area for health and safety hazards. There are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, carbon monoxide detectors and fully charged fire extinguishers of size 2A10BC or bigger. Telephones were observed in each classroom. 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, books, arts and other learning materials available for children in classrooms. Furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. Bathrooms were located in each classroom. All toilets, hand washing facilities are in working condition with proper sanitation in place. Facility has drinking water available for children. All the materials and surface accessible to the children is clean and toxic free. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. Artificial grass was observed under the play structures to prevent any fall or injuries. LPA observed water bottles for children playing in playground. Cubbies were available for children to store their belongings in each classroom. LPA reviewed facility records. LPA reviewed 8 random children's and 4 staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's record contains the record of immunization. All Posting requirements were met. Parent’s rights poster, emergency disaster plan and all other required licensing documents were observed to be posted in classrooms. Posters for COVID-19 symptoms, social distancing and other important information were observed to be posted. Masks, sanitizers and cleaning wipes were available in the facility. LPA reminded the facility, As of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encouraged the facility to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates

>Type B deficiency was cited today under Title 22 Division 12 of the California Code of Regulations.

This report and rights to comment and appeal were discussed with Leonida. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from the date of visit. Facility was advised for any additional questions to call office, M-F, 8AM-5PM at 650-266-8800 . For Rules and Regulations, visit the Website: www.cdss.ca.gov
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021
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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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: SFUSD-TULE ELK PARK AT MARINA EARLY EDUCATION
FACILITY NUMBER: 384003091
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/30/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/09/2021
Section Cited

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101174…Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.
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This requirement is not met as evidenced by records reviewed. Based on facility’s log reviews, last drill was conducted on 8/29/19.
This poses a potential heath and 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: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 07/30/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2021
LIC809 (FAS) - (06/04)
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