384004419-6-16-2021-05-CC-AMEN-C42V2V-20210616160347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004419
Report Date: 06/16/2021
Date Signed: 06/16/2021 04:03:52 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:	RAMSEY, MARY		FACILITY NUMBER:	384004419
ADMINISTRATOR:	RAMSEY, MARY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 793-1820
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94115
CAPACITY:	14	CENSUS:	DATE:	06/16/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Mary Ramsey		TIME COMPLETED:	02:30 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	Due to COVID-19, field visits are suspended at this time. Licensing Program Analyst (LPA) Andrea Medlin met with applicant for a prelicensing visit. This is a change of location. Applicant/Licensee acknowledges that the previously licensed location (Lic 384002004) will be automatically forfeited once this location is licensed. San Francisco Fire Department (SFFD) has approved the fire clearance on 6/1/2021. Days and hours of operation: Monday-Friday 7:30AM-6:00PM. Applicant states she is the only one who resides in the home. Applicant advised that any person 18 years of age or older who lives here, or provides any care and supervision to daycare children, shall have criminal record clearance on file. Applicant rents this home; control of property documents verified and obtained during the visit. The entire home is inspected for health and safety hazards. This is a two level apartment; on the upper level there is: one bedroom, closet, and bathroom, on the first (lower) level there is: living room, kitchen, bathroom, bedroom (converted into a daycare area, garage, and outdoor yard. The child care areas will be the entire first (lower) level and the outside patio area. Since the outside patio area is only partially fenced, children will need to be visually supervised at all times while outside. The entire second level of the home is off limits. The home has a working smoke detector, carbon monoxide (CO) detector, and a fully charged fire extinguisher. First aid supplies are available. Applicant will use the bedroom (daycare room) for the isolation/ill child area. Per applicant, there are no pets and no firearms or weapons in the home. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present in the home. Per applicant, she plans to purchase liability insurance for the child care. There are sufficient, age appropriated toys, and children's equipment in the day care area. Bathroom is clean and hazardous material is inaccessible to children. Applicant will provide and prepare meals and snacks for children. Applicant advised to conduct emergency disaster drills at least once every six months and log the date and time of the drill. (Continued on next page 809-C)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

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: RAMSEY, MARY	FACILITY NUMBER: 384004419
	VISIT DATE: 06/16/2021

NARRATIVE

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If applicant provides care to the 13th and 14th child, who must be school aged, parent notification and landlord consent is required. The following is required to be posted in an accessible location in view of parents: Emergency Disaster Plan (LIC 610), Parent's Rights (LIC 995A), and License (once received).

This home meets the licensing requirements of a Large Family Child Care Home (FCCH) today and licensure is recommended and approved as of today, 6/16/2021..

This report is reviewed with applicant and a copy of this report must be made available for public review upon request.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

LIC809 (FAS) - (06/04)

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