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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504389
Report Date: 04/05/2024
Date Signed: 04/05/2024 10:42:01 AM

Document Has Been Signed on 04/05/2024 10:42 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SFUSD-DR. WILLIAM COBB (EES) PRESCHOOLFACILITY NUMBER:
380504389
ADMINISTRATOR/
DIRECTOR:		SLIFE, CHADFACILITY TYPE:
850
ADDRESS:2725 CALIFORNIA STREETTELEPHONE:
(415) 749-3505
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 20DATE:
04/05/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Lead Teacher, Joselyn ManigqueTIME VISIT/
INSPECTION COMPLETED:
10:55 AM
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On 4/5/2024, at approximately 8:40AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced visit at the facility. LPA met with Lead Teacher Joselyn Manigque (S1). LPA explained the purpose of the visit. Present during the visit were 11 teachers and 20 preschool age children.

LPA inspected the facility for any health or safety hazards. The facility operates on the campus of Dr. William Cobb Elementary School. The facility uses two rooms, Room 3 and Room 4. Room 4 has children in care for four hours a day. LPA observed four staff supervising nine children in Room 3. There were seven staff supervising 11 children in Room 4. LPA observed the facility to be in clean and orderly condition. Furniture is age-appropriate and free of rough or sharp edges. Electrical outlets are covered to be inaccessible to children. There are fully charged fire extinguishers present in the facility. There are smoke and carbon monoxide detectors present. Children nap on cots and bring bedding from home. The facility provides breakfast, lunch, and snacks for children in care. Menus are posted and visible in each classroom. The school district provides food for the facility. There are bathrooms located in each classroom. Each bathroom has two toilets and two hand washing sinks. LPA observed a complete first aid kit to be kept in an emergency bag. Per S1, there are no firearms or weapons stored in the facility.

LPA observed the outdoor play area to be free of debris and other loose articles. There are age-appropriate toys and equipment for children in care. There is a play structure that is intended for use by children from two years to five years old. There is resilient padding for the play structure. There are no pools or other bodies of water present in the facility.

Water is available and accessible for children when needed. Lead testing was completed before 1/1/2023, and there were no exceedances in fixtures that provide drinking water.


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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2024
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SFUSD-DR. WILLIAM COBB (EES) PRESCHOOL
FACILITY NUMBER: 380504389
VISIT DATE: 04/05/2024
NARRATIVE
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LPA reviewed five personnel records, five children’s records, and facility records. LPA observed there to be at least one staff member with current First Aid/CPR certification. LPA advised that staff files should be reviewed so that all staff files are current. Immunization records are available for review. All individuals working in the facility are fingerprint cleared through SFUSD. LPA observed all children’s files to be complete. All required postings are posted and accessible for review. Drills are conducted and logged on a calendar in the Main Office.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a
maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.



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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SFUSD-DR. WILLIAM COBB (EES) PRESCHOOL
FACILITY NUMBER: 380504389
VISIT DATE: 04/05/2024
NARRATIVE
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies were cited on today's visit on 4/5/2024.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Joselyn Manigque.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024
LIC809 (FAS) - (06/04)
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