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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004296
Report Date: 04/14/2022
Date Signed: 04/14/2022 03:18:21 PM


Document Has Been Signed on 04/14/2022 03:18 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:MIO-PRESCHOOLFACILITY NUMBER:
384004296
ADMINISTRATOR:CANDICE CACERASFACILITY TYPE:
850
ADDRESS:2235 MISSION STREETTELEPHONE:
(415) 655-3756
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:15CENSUS: 9DATE:
04/14/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Candice Cacaras TIME COMPLETED:
03:35 PM
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On 4/14/2022 at 2:25P.M., Licensing Program Analyst (LPA) Luis J. Gomez met with Director, Candice Caceras. Purpose of the inspection was explained and was for a plan of correction inspection established on 3/30/2022. Present was the director and two staff supervising 9 children. All children present were preschool age and had been properly sign-in. LPA inspected facility with director for health and safety hazards.

During today's inspection, LPA reviewed the facility records. LPA observed all classroom personnel had updated the required mandated reporter training certifications (AB1207). Certifications were stored in each staff file and expire, 4/7/2024.

Per director, she has registered for an EMSA- approved cardiopulmonary/ first aid course that will take place on, 5/13/2022. Director's proof of enrollment was submitted during inspection. LPA advised director to submit updated certification to the department once course is completed.

Deficiencies issued on 3/30/2022, have been cleared and ‘Cleared Plan of Correction Letter’ was provided to Director.

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was discussed with Director, and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Director 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: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022
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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