<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004450
Report Date: 08/23/2021
Date Signed: 08/26/2021 07:37:03 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:YMCA SF CHINATOWN-TUNGLOK EARLY LEARNING CENTERFACILITY NUMBER:
384004450
ADMINISTRATOR:SENORES, ANNEFACILITY TYPE:
830
ADDRESS:75 VALLEJO STREETTELEPHONE:
(415) 452-7582
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94111
CAPACITY:21CENSUS: 0DATE:
08/23/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Anne SenoresTIME COMPLETED:
02:00 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) Glenn Schnell met with applicant Anne Senores today for a pre-licensing inspection. This inspection included a technical assistance inspection for COVID-19 guidance and support. The applicant is requesting 21 infants (ages birth to two years old). The infant program will be part of a combination center as the applicant has also applied for a preschool license for 36 children (ages two years old to entry into first grade) The facility plans to operate Monday - Friday; 7:00 AM to 6:30 PM. The designated director/site supervisor for the facility will be Gregory Flores. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.

Indoor Infants: There are two classrooms that will be used for the infant program. The following total square footage was calculated for rooms 103 and 108 room: 838.625 sq ft divided by 35 sq ft equals 23 children. The classrooms are observed today to be clean and equipped with fire extinguisher, smoke and carbon monoxide detectors, cubbies for infants personal belongings, a crib area with sufficient cribs, cots for older infants. The changing table is located in a shared bathroom between the classrooms and there are two changing tables within arms reach of a sink, and age appropriate toys and equipment for infants. There is storage for infants personal belongings, bedding and other items provided by the parents for the care of individual infants. Parents will provide disposable diapers and wipes for their infants. There is a food preparation area located between the classrooms which includes bottle warmers, microwave, sink and refrigerator, dishwasher.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
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 3
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: YMCA SF CHINATOWN-TUNGLOK EARLY LEARNING CENTER
FACILITY NUMBER: 384004450
VISIT DATE: 08/23/2021
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
26
27
28
29
30
31
32
Food is provided by the parents. Food for each infant is stored in the kitchen area or refrigerator and foods will be properly labeled with the child's name and date. Once children begin to transition to table food, the program will provide the foods through a catering service. Applicant was reminded that cleaning products and other chemicals are not to be stored with any foods. Parents will provide bottles/nipples and any other food service items for their own individual infants and the staff will ensure these items are sent home with the infants each day. Napping equipment for older infant children developmentally too old for a crib will be a cot with sheets and blankets will be provided by the program and the napping equipment and bedding will be laundered daily. Drinking water for the children will be provided by plastic baby water bottles or cups with lids provided by the parents. Medications for infants will be stored in the food preparation areas in high cabinets or in locked boxes in the refrigerator. The food service area and diaper changing area are located in separate areas between the classroom. All furnishing and equipment is observed to be safe and in good condition. There are garbage cans with tight fitting lids. The indoor space is equipped with a fire extinguisher, smoke and carbon monoxide detectors, first aid and emergency supplies. There are three sinks in the infant classroom for children's usage. All sinks accessible to children deliver water no warmer than 120 degrees. There are 2 toilets for infants in the infant room. There is a separate bathroom for staff. The isolation room for ill infant will be in the directors office.

Outdoor Infants: The outdoor area for Infants measures 938.013 square feet allowing for 12 infants. LPA advised that a waiver will need to be approved for scheduled rotational usage. Applicant will ensure all infants are provided with outdoor time each day. The outdoor area surface and equipment is observed to be clean, in good condition, and age appropriate. There are no climbing structures. The facility uses portable shade structures to provide shade for the children. Drinking water will be made accessible to children by water bottles provided by the parents. There is also a water fountain outside.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: YMCA SF CHINATOWN-TUNGLOK EARLY LEARNING CENTER
FACILITY NUMBER: 384004450
VISIT DATE: 08/23/2021
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
26
27
28
29
30
31
32
The following items were reviewed as part of today's visit: Record keeping for staff, children and facility records, maintaining and updating needs and service plans for infants, Care and Supervision of the Children, Child Discipline Procedures- talking and redirection will be used, Emergency Evacuation Procedures-the facility will conduct monthly disaster drills and a log will be maintained for review upon request. , Medication Policies, Isolation of Sick Children, Napping Requirements (Safe Sleep and SIDS discussed), Completion of Individual Infant Sleeping Plans and supervision of napping infants, Food Service for Infants, Transportation-none provided, Parents Rights, and Reporting Requirements. Applicant will ensure all require postings are displayed and visible to children’s authorized representatives at all times. The fire inspection was conducted, and approval was received on 8/2/21. The building was constructed after 2010 so there is no requirement for the testing of lead in the water per H&S Code 1597.16.
This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 Continued on next page.
LPA also reviewed COVID-19 required postings. LPA reviewed the COVID-19 self assessment guide with the applicant. Applicant was informed that access to available Personal Protective Equipment (PPE) may be available through the local child care resource and referral agency.
Report was reviewed and signed by Applicant, Anne Senores. Today’s report, 8/23/21, will be sent to Anne Senores at asenores@ymcasf.org by close of business, 8/23/21. Confirmation of receipt is required.
LPA Schnell will recommend a 60 day provisional license for this program for a capacity of 21 once verification of bank funds is received and the request for the waiver and rotation schedule is received.
A regular license will be recommended once the follow is received and verified to be correct. These items are due before the provisional license expires:
-Revised page 29 of the Personnel Handbook
-Picture showing playground construction complete
-Picture of COVID postings in place.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3