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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000274
Report Date: 12/06/2022
Date Signed: 12/06/2022 11:56:44 AM

Document Has Been Signed on 12/06/2022 11:56 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:FAMILY CONNECTIONS CENTERS - PRESCHOOLFACILITY NUMBER:
384000274
ADMINISTRATOR:TAM, TINAFACILITY TYPE:
850
ADDRESS:2565 SAN BRUNO AVENUETELEPHONE:
(415) 715-6746
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 5DATE:
12/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:41 AM
MET WITH:Tina TamTIME COMPLETED:
12:00 PM
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On December 6, 2022 at approximately 09:30AM, Licensing Program Analyst (LPA) Nathan Garcia met with Director Tina Tam for an annual inspection. Purpose of the inspection was explained. Present, in the facility are Director, support staff, 1 teacher with a teacher assistant, supervising 5 children. Facility is operating within its capacity and is in compliance with staff/child ratio on this day. Facility operates day care from Monday - Friday 09:00am to 12:00pm for the morning program and 1:00-4:00 pm for the afternoon program.

With the Director, LPA inspected the day care rooms and LPA observed facility has smoke detectors, carbon monoxide detectors, 2 fully charged fire extinguisher model 3A40BC located in the kitchen and and front office and working telephone on site. The center has total of 3 classrooms. The center has 2 children bathroom available. It also has a staff bathroom that is located near the entrance of the preschool classrooms. LPA observed the kitchen and all cleaning solutions, poisons, and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age-appropriate furniture. Facility floor is in good repair and free of any hazards.

There are first aid supplies available in the classrooms and in the office. All bathrooms are in working condition. All food is stored properly to avoid contamination. All foods are brought from home and they are kept in insulated bags, properly labeled. All food preparation area is free of litter. Individual items provided by the parents are labeled and stored appropriately. There is water available for children in the classrooms and emergency bags. Per director, the outdoor area is a public space that is utilized mostly by staff members. The space is also used by children for masks breaks and have garden area for the children to participate in gardening activities.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2022
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: FAMILY CONNECTIONS CENTERS - PRESCHOOL
FACILITY NUMBER: 384000274
VISIT DATE: 12/06/2022
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LPA observed that facility is using Google forms and word documents for sign in/out. Facility has license and all other required documents posted and visible for the public. Facility has an emergency drill log, per Director, drills are done every other month and most recent was an earthquake drill on 10/26/22.

The LPA reviewed the facility records. LPA reviewed children's files. LPA reviewed all 2 staff files with qualifying requirements such as ECE Units and CPR and Mandated Reporter Training Certificates. All files reviewed were present in everyone’s folder.



The Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare 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.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

This facility does not have children that requires special medication. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was 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

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.

A copy of this report was given to the Director and a site visit notification must be posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Tina Tam.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022
LIC809 (FAS) - (06/04)
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