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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505039
Report Date: 07/28/2022
Date Signed: 07/28/2022 12:43:32 PM

Document Has Been Signed on 07/28/2022 12:43 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:CCFC-30TH AVENUEFACILITY NUMBER:
380505039
ADMINISTRATOR:SEAN OWENSFACILITY TYPE:
850
ADDRESS:741 30TH AVENUETELEPHONE:
(415) 668-6539
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY: 29TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
07/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Yan Liu (Center Manager)TIME COMPLETED:
01:10 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the Ste Director, Yan Liu (Center Manager). The purpose of the inspection was explained to her. There were 8 children with 2 teachers and a center manager present. The facility met with the teacher/child ratio. The operation hours of the facility were Monday to Friday from 7:30AM to 5PM during Pandemic. Per Yan, the regular operation hours were Monday to Friday from 7:30AM to 5:30PM. LPA inspected the facility for health and safety hazards. There were total of two connected classrooms, two bathrooms, and the office on this site. Two bathrooms with total of 4 toilets and 4 faucets available for children's use. Separated staff bathrooms were available for staffs. The children's bathroom was clean and free of harmful object. There was a diaper changing station with pad and arm reach sink available. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were made inaccessible to the children. All lower cabinets were latched. Gates were installed at the entrance of the bathroom, diaper changing station, and hallway to the food preparation area. The food waste trash can had tide lid. Classroom was clean, safe, and were set up with age appropriate furniture, equipment, and materials. All toys, equipment and furniture were in good condition and repaired. Facility provided breakfast, lunch and PM snack to children and was delivered from the central kitchen. Drinking water was served in water pitchers with paper cups. There were a small fish tank with tide lid in the classroom. All electrical outlets were covered. First aid supplies were available for children in each classroom at the center. Cots were used for napping. The facility has provided the bedding to each child. The facility also has washed the bedding for the children weekly. Emergency supplies were available at the Facility. Sick children will be separated from the group and place in the office while waiting for their parents to pick up. Facility had its own outdoor play area at the property. The outdoor play yard was completely fenced. Outdoor toys, play structure, and sandbox were available for children and seems safe and age appropriated. The facility installed the soft cushioning to the entire ground to prevent injury. Facility has posted the required forms (ie License, snack menus, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). Fire Earthquake drills have been done about every month and was properly logged. LPA inspected the sign in/out during the inspection. All of the staffs has current CPR and First Aid training, they will expire in 9/2023. LPA also reviewed the children's and staff's files during the inspection. All staff had current Child Abuse Mandated Reporter Training. They will expire in 7/2024.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2022
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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