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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004534
Report Date: 02/16/2022
Date Signed: 02/16/2022 01:53:11 PM


Document Has Been Signed on 02/16/2022 01:53 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:SUNSHINE ADVENTURES NOB HILLFACILITY NUMBER:
384004534
ADMINISTRATOR:MIDLYN CHENFACILITY TYPE:
850
ADDRESS:1439 PACIFIC AVETELEPHONE:
(415) 699-5820
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY:24CENSUS: 0DATE:
02/16/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:02 AM
MET WITH:Midlyn ChenTIME COMPLETED:
11:03 AM
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On February 16, 2022 at 9:00 AM, Licensing Program Analysts (LPA) Sheran Lo met with Applicant Midlyn Chen today for a pre-licensing inspection. This inspection included a technical assistance inspection for COVID-19 guidance and support. The applicant is requesting 24 children (ages 2 years to entry into first grade). The facility will operate Monday - Friday; 8:00 AM to 6:30 PM. The designated director/site supervisor for the facility is also applicant. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.

Indoor: There are two classrooms that will be used for the program and the following square footage was calculated for each room: Room 1- 590 sq ft. and Room 2- 240 sq ft. Total useable indoor square footage is 855 sq ft divided by 35 sq ft equals 24.428 children. 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. There is storage space for children's personal belongings and cots to be utilized for napping children. Facility will wash children's bedding weekly or as needed. Cots will be cleaned at least weekly or more often if needed. Children will be signed in and out with a sheet to be kept in classrooms. The indoor space is equipped with a fire extinguisher, smoke and carbon monoxide detectors, separate kitchen area where snack food is stored, garbage cans with tight-fitting lids, first aid and emergency supplies. The facility is adequately ventilated and free of insects and bugs. Windows are high up inaccessible to children. The program provides two snacks daily and parents will provide lunch. Only disposable products will be used for food served by the facility. Snack foods will be stored in the kitchen separately from any cleaning products or other hazards. Medications will be stored in the classroom cabinet area inaccessible to the children; there is a refrigerator located in this area for refrigerated medications.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2022
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 2


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: SUNSHINE ADVENTURES NOB HILL
FACILITY NUMBER: 384004534
VISIT DATE: 02/16/2022
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There are _2 toilets (30 capacity) and 2 sinks (30 capacity) accessible for children's use. Bathrooms are located either inside the classrooms or in the hallway. The bathrooms were observed to be clean and with no health and safety hazards. Sinks accessible to children deliver water that is no warmer than 120 degrees. The program will provide a water dispenser and individual cups for children to drink water indoors. All toxins and other hazardous items will be stored in a locked cabinet in the classroom and will be inaccessible to children. Isolation of ill children will be located in the adult bathroom will be used for an ill child.

Outdoor: The outdoor area measures 300 sq ft. allowing for a total of 4 children. The outdoor area to be used is enclosed by at least a four foot fence and observed to be clean, safe and equipped with toys and equipment for children. Resilient material located under climbing applicable climbing structures is a pour and play soft padding. There will be individual water bottles to allow children access to drinking water outside. Shade for children will be provided by building structures.

Required postings were observed during today's inspection. Facility will conduct monthly disaster drills and a log will be maintained for review upon request. The fire inspection was conducted, and a copy of passed was received. The requirement for Lead Water Testing was discussed (H&S Code 1597.16). Information was provided to applicants during today's inspection. Advisory Note provided to applicants stating that the requirement for testing must be met by January 2023.

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

An electronic copy of this two page report was emailed to applicant Midlyn Chen.

LPA Lo will recommend licensure of this facility for a capacity of 24 children once manager approves. Facility will have waiver for public playground use.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
LIC809 (FAS) - (06/04)
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