384000199-1-18-2024-05-CC-LGOZ-CZLU9Z-20240118142359

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000199
Report Date: 01/18/2024
Date Signed: 01/18/2024 02:24:53 PM

Document Has Been Signed on 01/18/2024 02:24 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CHILDREN'S DAY SCHOOL, INC.		FACILITY NUMBER:	384000199
ADMINISTRATOR:	GREENE, ANTONETTE B.		FACILITY TYPE:	850
ADDRESS:	333 DOLORES STREET		TELEPHONE:	(415) 861-5432
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 56	TOTAL ENROLLED CHILDREN: 56	CENSUS: 40	DATE:	01/18/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Antonette Greene		TIME COMPLETED:	02:35 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	On 1/18/2024 at 8:45AM., Licensing Program Analyst (LPAs), Luis Gomez and Yasha Nasiripour met with Director, Antonette Greene. Purpose of inspection was explained and was for an Unannounced, Annual Random inspection. Facility has request to add an additional, shared, outdoor play space located at the Boys and Girls Club (450 Guerrero Street, San Francisco, CA, 94110). This facility is licensed to operate a preschool program. Present during inspection was the Director and 8 staff supervising 40 children. Children present had been properly signed in. The preschool program utilizes three classrooms: St. Joseph’s Hall: Classroom #109, #112; and the 16^th Street Classroom (Annex Building). For outside play facility utilizes one, shared, outdoor play area (Lower Yard). LPAs reminded director post outdoor waiver for rotational use of Lower Yard. LPAs inspected facility for health and safety hazards. At 9:10AM., the following was observed: Classrooms were clean with age-appropriate materials available. The floor and ground surfaces were clear of obstructions or hazards. Each classroom was equipped with cubbies for children's belongings. Accessible furniture, books, art supplies inspected were free of sharp corners or splinters. Facility has child- sized tables and chairs available for seated activities. The children’s bathroom, located in hallway was clean with fixtures in operating condition. Per Director, the staff bathroom is located separately. For napping services, LPAs observed foldable mats, made from a cleanable material. Per director, napping supplies are washed weekly by authorized representatives. The facility has adequate ventilation, comfortable temperature, and lighting. Facility has a built-in smoke detectors, testable carbon monoxide detector, telephone service, and fire extinguishers: 2A:10:BC located in hallway. LPAs reviewed first aid kit during inspection. (REFER TO 809c, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

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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Document Has Been Signed on 01/18/2024 02:24 PM - It Cannot Be Edited

Created By: Luis Gomez On 01/18/2024 at 12:19 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHILDREN'S DAY SCHOOL, INC.	FACILITY NUMBER: 384000199
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	At 11:15AM., Based on record review, LPAs confirmed staff's required 'Mandated Reporter Training' (AB1207) were missing from the facility records. This poses a potential health and safety risk to children in care.
	POC Due Date: 01/29/2024
	Plan of Correction
1 2 3 4	Director will submitted staff's completed 'Mandated Reporter Training Certification' (AB1207) by due date: 1/29/2024.

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	At 11:25AM., Based on record review, LPAs confirmed staff's proof of required immunization were missing from facility records. This poses a potential health and safety risk to children in care.
	POC Due Date: 01/29/2024
	Plan of Correction
1 2 3 4	Director will submit staff's proof of immunization by the due date: 1/29/2024.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Luis Gomez

LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

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: CHILDREN'S DAY SCHOOL, INC.	FACILITY NUMBER: 384000199
	VISIT DATE: 01/18/2024

NARRATIVE

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(Page 2)
At 9:45AM., LPAs inspected the outdoor play yard (Lower Yard). The lower yard was completely enclosed with several large umbrellas available for shaded rest. Climbing structure was observed properly anchored with absorbent material installed for added safety. LPAs observed water services are provided for children both inside and outside.

At 9:55AM., LPAs inspected the Outdoor Play Yard #2 (Boy and Girls Club). Outdoor play yard #2 has a turf padding for added safety. A shaded rest area is available with sufficient seating. Per director, water service will be provided with use of a water container and refillable cups. Fire Clearance Request was granted on 5/9/2023. Outside Play Yard #2 was measured by LPA on 6/20/2023, and has a total useable square footage of 5,762 sq ft. The total usable area divided by 75 sq ft allowing for 76 children.

At 10:50AM., LPAs reviewed facility records including: 4 children’s files and 8 personnel files. Staff’s files were reviewed and contained the: Teachers Qualifications and the Personnel Record.

LPAs reminded director to ensure staff’s Notice of Employee Rights (LIC9052), and Health Screening Form is stored in facility files.

At 11:15AM., Based on record review, LPAs confirmed staff's required 'Mandated Reporter Training' (AB1207) were missing from the facility records.

At 11:25AM., Based on record review, LPAs confirmed staff's proof of required immunization were missing from facility records.

The children’s files were reviewed, containing the: Immunization Records, Identification and Emergency Information (LIC700); Notification of Parent’s Rights (LIC995); Personal Rights (LIC613A) and ‘Written Medical Assessments’.

Facility personnel had their updated CPR/ 1^st aid certification on file, expiring on 9/2025.

Site’s emergency disaster drills are conducted every six months, with last drill completed on 9/27/2023.

Required posting have been posted in each classroom and includes the: Facility License; Notification of Parent’s Rights (PUB394); Passenger Safety Law (PUB269); Updated Snack Menu; and Emergency Disaster Plan (LIC610). (REFER TO 809c, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: CHILDREN'S DAY SCHOOL, INC.	FACILITY NUMBER: 384000199
	VISIT DATE: 01/18/2024

NARRATIVE

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For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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-care-centers/.

Assembly Bill (AB) 2370, chapter 676, statues 2018 requires all licensed child care centers (CCC’s) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and every five years after the date of the first test.

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

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations and cited on 809D. Exit interview, report, and plan of correction was discussed with Director, Antonette Green. Director’s signature on this form acknowledges receipt of these documents.

Prior to adding Outdoor Play Area #2, facility must complete the following:
-Submit procedures for staff to complete prior to use.

This report must be made available in the facility for public review. Notice of site visit was provided and must remain posted for 30 days. Director was advised any additional questions to call office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

LIC809 (FAS) - (06/04)

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