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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004296
Report Date: 02/10/2021
Date Signed: 03/02/2021 08:51:48 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:MIO PRE-SCHOOL TOOFACILITY NUMBER:
384004296
ADMINISTRATOR:BLEA,TERESAFACILITY TYPE:
850
ADDRESS:2235 MISSION STREETTELEPHONE:
(415) 519-2922
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:25CENSUS: 9DATE:
02/10/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Teresa BleaTIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analysts (LPA) Glenn Schnell and Jazmin Gill met with Applicant Teresa Blea today for a pre-licensing inspection. This inspection included a technical assistance inspection for COVID-19 guidance and support. The program is currently operating under an initial approved waiver to provide care to essential workers families only during the COVID-19 pandemic. The applicant is requesting a total capacity of 15 children (ages two years to entry into first grade). The facility will operate Monday - Friday; 7:00 AM to 6:00 PM. The designated director/site supervisor for the facility is Candice Caceras. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.

Indoor: There is one large classroom that will be used for the program and the following square footage was calculated to be 1416.810 sq ft., divided by 35 sq ft equals 40_children. Upon entry into the facility, the front space has children's cubbies for personal storage items. Walking past the cubbies, there is a set of approximately six wide steps that drops down to a lower level, where there is an office space children and families need to walk through to get to the space for children. The office space is partially divided from the space for children by a portable partition, making the office space accessible to the children. After walking through the office, the children's classroom begins and the children's bathroom is located at the back of the facility. The indoor space for children is observed today to be clean and all furnishing, toys and equipment observed to be safe and in good condition.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2021
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 6
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: MIO PRE-SCHOOL TOO
FACILITY NUMBER: 384004296
VISIT DATE: 02/10/2021
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There is a table and shelf located in the back of the children's classroom that holds a small refrigerator and microwave and extra snack foods and disposable paper products and plastic ware in the event these items are needed for any emergencies. Mats will be utilized for napping children. Storage and cleaning of mats was discussed. Parents will provide a sheet and blanket for their child, bedding will sent home to be laundered weekly. During the COVID-19 pandemic, it is recommended that bedding be sent home daily to be laundered. Mats will be cleaned at least weekly but during the pandemic will be sanitized daily by staff. The indoor space is equipped with a fire extinguisher and smoke detectors. Applicant will purchase a carbon monoxide detector for the facility. There are garbage cans with tight-fitting lids. There is a first aid kit that needs to be replenished with needed supplies. The facility is adequately ventilated and free of insects and bugs. The program currently will not be providing food service during the pandemic. Parents provide all foods at this time. If the applicant chooses to provide food services in the future, applicant will notify Community Care Licensing before that is implemented. The program currently does not provide medication administration or incidental medical services to children as part of their program. There is one toilet (15 capacity) and one sink (15 capacity) accessible for children's use. Broad based step stools will be used to assist children when using the sink and toilet. The bathroom was observed to be clean and with no health and safety hazards. The sink accessible to children delivers water that is no warmer than 120 degrees. The program will provide filtered water and cups for children to drink water indoors. All toxins and hazardous items will be stored in locked cabinets in the classroom or on high shelving and will be inaccessible to children. LPA observed ledges built into the sides of the walls of the facility that are tall enough to store items out of children's reach, however, due to the possibility of falling hazards in an earthquake, LPA recommended that a netting or bungee cord be used to secure items on these ledges. Isolation of ill children will be located in the office space of the facility office and staff bathroom will be used for an ill child.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: MIO PRE-SCHOOL TOO
FACILITY NUMBER: 384004296
VISIT DATE: 02/10/2021
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This report was amended on 3/24/21

There are three storage areas in the classroom with a cloth drape separating the storage rooms from the children; one located in the front, one in the middle under a staircase, and one located in the back next to the children's bathroom. Since drapes do not make the spaces inaccessible to the children, the applicant will ensure all hazards inside these storage spaces are inaccessible to the children. Applicant plans to place a gate on the entry way at the front of the classroom.

There is a staircase located in the mid part of the classroom that leads to a second level of the building. The bottom of the staircase is blocked so children have no access to the stairs.

Outdoor:
This facility does not have adequate outdoor space and the limited space available is on the second level of the building. The applicant is in the process of obtaining an open space waiver to use Mission Playground on the side of Valencia Street for outdoor activity space. The park is located at 19th Street and Valencia Street, in San Francisco approximately one quarter of a mile from the facility. Applicant has obtained the appropriate permit issued by San Francisco Parks and Recreation. Applicant needs to submit a form request for the open space waiver. Conditions of the waiver requirements were discussed with the applicant today. Once this waiver request is received and reviewed, LPA will conduct an additional inspection to review the conditions and evaluate the proposed public park to be used.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: MIO PRE-SCHOOL TOO
FACILITY NUMBER: 384004296
VISIT DATE: 02/10/2021
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This report was amended on 3/24/21. The following items were reviewed as part of today's visit: Sign in-out procedures- children will be signed in and out by parents using a sign in-out sheet. During the COVID-19 pandemic staff will be signing children in and out. Record keeping for staff, children and facility records, Care and Supervision of the Children, Child Discipline Procedures- staff will talk with the children and use redirection, Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements. Required postings were observed during today's inspection, but not all were observed.

The facility staff will conduct monthly disaster drills and a log will be maintained for review upon request. The fire safety inspection in still in process at this time.

This program will not provide Incidental Medical Services – IMS at this time. 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
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MIO PRE-SCHOOL TOO
FACILITY NUMBER: 384004296
VISIT DATE: 02/10/2021
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This report was amended on 3/24/21

LPA's Schnell and Gill conducted review of the completed COVID-19 Self Assessment form during today's inspection. Applicant provided the form to LPA's during today's inspection. LPA's also reviewed COVID-19 required postings and provided additional COVID-19 resources to applicant. Applicant was informed that access to available Personal Protective Equipment (PPE) may be available through the local child care resource and referral agency.

An electronic copy of this six page report was emailed to applicant Teresa Blea on 2/11/2021. Applicant was asked to review the report and return a signed copy of the report to LPA Schnell.

LPA Schnell will recommend licensure of this facility for a capacity of 15 children once the following is received:
-Approved fire safety clearance from San Francisco Fire Department.
-LPA receives a signed copy of this six page pre-licensing report.
-Completion Open Space Waiver Request with supporting documentation. Request will need to be reviewed and approval be given.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: MIO PRE-SCHOOL TOO
FACILITY NUMBER: 384004296
VISIT DATE: 02/10/2021
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The report was amended on 3/24/21
-Storage shelf and table with microwave and mini-refrigerator need to be cleaned and organized.
-Remove any hazards that may be accessible to children in classroom storage closets with clothe drapes for doors or make storage closets completely inaccessible to children.
-Table used as teacher desk in classroom needs to be cleaned and cleared of hazards
-Purchase and install a carbon monoxide detector.
-All hazards accessible to children in the office area need to be removed and made inaccessible to children; scissors, permanent ink markers, ink cartridges, stapler, any other hazards.
-First Aid kits needs to have the following: Current copy of First Aid manual, tape, tweezers, scissors, thermometer, antiseptic solution/wipes.
-The following required postings need to be posted: Parents Rights Poster, Daily Program Schedule, Personal Rights Form, Car Seat Law, Earthquake Preparedness Checklist.
-Proof of completion of Orientation Component 1, Mandated Reporter Training for Teresa Blea.
-Copy of LIC 9108 form completed by Teresa Blea
-Proof of completion of EMSA certified Lead poison training for Teresa Blea and Candice Caceras
-LIC 404 form completed by the bank, verifying applicant finances. This form was already sent to the bank, with no response to date.
-Corrected Monthly Operating Statement (LIC 401)
-Corrected Personnel Report (LIC 500)
-Corrected B documents: Admission Agreement, Job Descriptions, Personnel Policies, In-Service Training Plan, Parent Handbook, Discipline Policies, Daily Schedules, and List of furniture and equipment.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6