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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004457
Report Date: 08/26/2020
Date Signed: 08/26/2020 02:57:50 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:2ND GENERATION CABOT (SA)FACILITY NUMBER:
414004457
ADMINISTRATOR:ALCANTARA, RACHYLFACILITY TYPE:
840
ADDRESS:342 ALLERTON AVETELEPHONE:
(650) 225-3666
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:40CENSUS: DATE:
08/26/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Maryann KlotovichTIME COMPLETED:
03:00 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
Due to the current COVID-19 pandemic, field visits are suspended at this time.

Licensing Program Analyst (LPA) Andrea Medlin conducted this case management visit by tele-inspection and met with Maryann Klotovich, Regional Manager. The purpose of this visit is due to a request to increase capacity and add rooms for child care purposes. Facility is currently licensed to serve 40 school aged children and requested an increase to accommodate up to 70 school aged children. South San Francisco Fire Department fire clearance is pending. Days and hours of operation for the school aged program are 6:30AM-6:30PM. Physical plant toured in the new requested areas to use for health and safety hazards. The new areas/rooms that will be used are: Ocean Fish multi-purpose room; Sea Bird multi-purpose room; Sea Turtle mulit-purpose room. Each room measures 699 square feet allowing for up to 19 children in each room. The three multi-purpose rooms combined equal 2,097 square feet allowing for a total of 59 children. There are fully charged fire extinguishers that meet minimum requirements, smoke detectors, and carbon monoxide (CO) detectors throughout the facility. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. Separate staff bathrooms are available. There are no changes to the outside school aged outdoor play areas. This facility meets the licensing requirements to increase capacity to 70 school aged children pending final fire clearance approval. Final licensure will be recommended upon fire clearance approval.

This report is reviewed with staff and provided by email. A copy of this report must made be available for public review upon request.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2020
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 1