414004154-11-21-2022-05-CC-AMEN-CLDW44-20221121155656

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004154
Report Date: 11/21/2022
Date Signed: 11/21/2022 03:57:00 PM

Document Has Been Signed on 11/21/2022 03:57 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:	SSFUSD HILLSIDE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	414004154
ADMINISTRATOR:	HAGER SULIMAN		FACILITY TYPE:	850
ADDRESS:	1400 HILLSIDE BOULEVARD		TELEPHONE:	(650) 827-8412
CITY:	SOUTH SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	72	CENSUS: 12	DATE:	11/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Hager Suliman		TIME COMPLETED:	04:10 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) Andrea Medlin met with facility representative for this required annual licensing visit. Purpose of visit explained. Days and hours of operation: Monday-Friday 8:00AM-4:00PM. There are 12 children present during the visit. Facility meets teacher/child ratio. This preschool program operates at Hillside school owned by South San Francisco Unified School District. Facility has use of classrooms: #20, #24, #25, and staff/health office and designated outdoor play area. Classroom #25 is not being used right now due to enrollment. Facility has an approved outdoor playground waiver to use the outside playground due to shared use with the SSFUSD special education children and a bathroom waiver to share with other program, though director states the special education program has relocated and is no longer on site. The facility has a fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and carbon monoxide (CO) detectors in facility. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per director, there are no firearms or weapons on site. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Variety of age appropriate toys and materials for children is available. Classrooms are set up for child care and furniture and equipment for children is present. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. Cots are available for napping and are individually labeled. Snacks and meals are provided by the facility. Adequate first aid supplies are available. Outdoor play area is inspected for health and safety hazards. The areas outside under climbing structures is cushioned with soft rubber. Outdoor activity spaces are fully fenced and surfaces are free of hazards. Facility has posted all the required licensing forms in prominent accessible locations. LPA reviewed staff and children's files. In the children’s files reviewed, all records are complete. In the staff files reviewed, all records are complete. Staff have the required mandated child abuse reporting training as compliant with AB1207. Some staff have current Pediatric First Aid and CPR certification. (Continued on next page 809-C)

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2022

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: SSFUSD HILLSIDE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 414004154
	VISIT DATE: 11/21/2022

NARRATIVE

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Incidental Medical Services (IMS) policy discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is 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. Facility informed that effective September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

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

Notice of Site Visit posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2022

LIC809 (FAS) - (06/04)

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