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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004033
Report Date: 09/07/2022
Date Signed: 09/07/2022 01:13:34 PM


Document Has Been Signed on 09/07/2022 01:13 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:FRIEDMAN, SHIFRA V. & PIL, MENACHEM M.FACILITY NUMBER:
384004033
ADMINISTRATOR:FRIEDMAN, SHIFRA V.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 756-9411
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:14CENSUS: 10DATE:
09/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Mandel PilTIME COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with one of the licensees, Mandel Pil, and 3 helpers. All adults had fingerprint clearance. The purpose of the inspection was explained to him. There were 10 children that included 4 infants with 3 helpers present. The name of the daycare was called " Kibbie Farm Day Care" The operation hours were Monday to Sunday from 8:AM to 5 PM, except Saturday. The licensee rented the 2 story singly family house with 2 bedrooms, 1 and 1/2 bathroom, living room, dining room, and kitchen on the upper level. The lower level had an in-law with 2 rooms, living room, & a full bathroom, a backyard, and a garage. The daycare areas were the entire lower level and backyard except the garage and upper level. The off-limit areas were the entire upper level and a garage. LPA toured and inspected the facility for health and hazard. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. Cubbies were available for the children to store their belongings by the main entrance. There were plenty of age-appropriate toys, books, learning material, art and craft material, and children's furniture available for the children. There was a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detectors, and first aid supplies available in the daycare. There were no guns, no weapons, and no pets at home. The facility has provided breakfast, AM/PM snacks, & lunch to the children. Mats and cribs were available for napping. All electrical outlets were covered. The licensee installed the carpets on the daycare floor to prevent injury. The children's bathroom was clean. The lower bathroom sink cabinet was locked and All toxins and harmful objects were made inaccessible to the children. The outdoor play yard was completely fenced. There were some outdoor toys, play house, and ride-on toys available for the children. Per licensee, he will temporarily close the yard for remodeling in September or October ths year. A helper had current CPR/First Aid training certificates, it will expire in 4/2023, and Mandated Reporter Training (AB1207) available for review during the inspection. There were no children on special medication. The facility had all required postings. LPA reviewed the staff and children's files during the inspection.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/07/2022
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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