414004018-10-15-2019-05-CC-HKAR-BGYUXW-20191015155901

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004018
Report Date: 10/15/2019
Date Signed: 10/15/2019 03:59:25 PM

COMPREHENSIVE INSPECTION

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:	HOLY ANGELS PRESCHOOL		FACILITY NUMBER:	414004018
ADMINISTRATOR:	CONCEPCION GONZALEZ		FACILITY TYPE:	850
ADDRESS:	20 REINER STREET		TELEPHONE:	(650) 303-1478
CITY:	COLMA	STATE: CA	ZIP CODE:	94014
CAPACITY:	28	CENSUS: 16	DATE:	10/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Conception Gonzalez		TIME COMPLETED:	04:20 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) Kaur and Mok met with Director, Conception Gonzalez for a random annual inspection. Purpose of the inspection was explained. Present, there are 16 children with 2 teacher, and the director. Facility is operating within the capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday between 07:30 AM to 06:00 PM. The facility is located in Holy Angel School property. With director, LPAs inspected the day care classroom #1 and #2 and play yard. Children were napping in classroom 1 with a staff. By classroom 1 there is small storage room for snacks. Facility provides snacks to children. Children bring their own lunches daily. There are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, carbon monoxide detectors and fully charged fire extinguishers on site. Facility has working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored in high cabinets and are inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. All toilets, hand washing facilities are in working condition with proper sanitation in place. Facility has drinking water available in the pitcher with cups for the children . Facility has first aid supplies available. All of the unused electrical outlets have child protective covers installed. The outdoor play yard is completely fenced. There is drinking water in play yard for children. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is enough rubber mat under the play structures to prevent any fall injuries. There is sufficient amount of shaded area available for children to use. See next page for continuation .............

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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: HOLY ANGELS PRESCHOOL	FACILITY NUMBER: 414004018
	VISIT DATE: 10/15/2019

NARRATIVE

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Continuation from previous page ..........
LPAs reviewed the facility records. LPA observed that facility has sign in / out record with full legal signatures. Facility has all of the required documents posted and visible for the public. LPA reviewed 5 random children's and all staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Facility has record of immunization of each child attending child care. LPAs observed facility has record of staff’s immunization on file. Director has valid CPR in file expires on 10/2019. LPA reviewed the educational qualification of all the teachers. Personal roster and children roster was collected from director. There are no children on special medication.
LPAs review AB 1207 with the director. Director is aware that as of January 1, 2018 all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

LIC809 (FAS) - (06/04)

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