384004300-3-9-2021-05-CC-HRCO-BYXNQ8-20210309093927

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004300
Report Date: 02/25/2021
Date Signed: 03/09/2021 09:39:42 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:	RICHMOND ACADEMY		FACILITY NUMBER:	384004300
ADMINISTRATOR:	WEI, JIAWEN		FACILITY TYPE:	850
ADDRESS:	3435 GEARY BLVD.		TELEPHONE:	(415) 260-0393
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94118
CAPACITY:	72	CENSUS: 0	DATE:	02/25/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Jia Wen Wei and Randall Choy		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Haydee Caliboso met with the applicant today for a follow-up pre-licensing inspection required for licensure. The purpose of today's inspection is to review corrections requested during the initial pre-licensing inspection conducted on 10/6/20. This inspection included a technical assistance inspection for COVID-19 guidance and support. The applicant has requested a capacity of 60 preschool children, ages 2-6 years old, with toddler option component, 12 children, ages 18-36 months old. The applicant made changes to the physical plan of the Main Classroom to accommodate the toddler children. There are 3 instructional classrooms and 1 gross motor classroom that will be used for the program. During today’s inspection, LPA observed the applicant installed a partition wall in the main preschool classroom to accommodate Toddlers Classroom. The applicant will ensure the wall partition is stable and safe. LPA discussed active supervision at all times with Director. Indoor: The main preschool classroom (#1) was calculated for a total of 1,606.5 sq. ft allowing for a total capacity of 45 preschool children. The main preschool classroom (#1) is divided into preschool classrooms and a toddler classroom. The Toddlers Classroom is physically separated from the preschool classroom using a partition wall. The square footage for the Toddler Classroom is 471.9 sq. ft. allowing for a capacity of 13 children. Cont. 809

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2021

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: RICHMOND ACADEMY	FACILITY NUMBER: 384004300
	VISIT DATE: 02/25/2021

NARRATIVE

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Classroom (#2) was 185.14 sq. ft, allowing for a capacity of 5 children. The Gross Motor Classroom was 1,119.96 sq. ft, allowing for a capacity of 31 children. The Gross Motor classroom will only be used for indoor gross motor activity. Classroom (#3) was 126.58 sq. ft, allowing for a capacity of 3 children. The total indoor classrooms measure 3,510.08 sq. ft., allowing for 72 children.

Additionally, the applicant has obtained a waiver request for designated time and space playground usage from SF Recreation Park to use Rossi Playground as an alternative playground, located 0.2 miles from the facility at 600 Arguello Boulevard in San Francisco. The program will provide field trip permission slips signed by all parents as part of the enrollment agreement. The facility does not have a designated outdoor play area.

During today’s inspection, LPA observed the following corrections have been completed:

The First Aid Kit is replenished and contains supplies that are available for children and staff usage. First aid supplies are accessible for staff but made inaccessible to children.
Napping mats are available and in a safe condition.
A carbon monoxide detector has been installed.
A door chime was installed.

The following was reviewed today:

COVID-19 Self-Assessment Guide

Cont. 809-C

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2021

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: RICHMOND ACADEMY	FACILITY NUMBER: 384004300
	VISIT DATE: 02/25/2021

NARRATIVE

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The following corrections need to be made and submitted for further review before a recommendation for licensure with a capacity of 72 can be made:

Obtain approval from San Francisco Fire Department
All required facility posting requirements are posted.
Updated indoor Facility Sketch LIC 999
COVID-19 required posters are posted.
A photo of Toddlers Classroom organized and set-up with age-appropriate toys that are in good working condition.
A photo of secure and stable wall partition in the Toddler Classroom.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2021

LIC809 (FAS) - (06/04)

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