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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000406
Report Date: 05/18/2022
Date Signed: 05/18/2022 01:33:19 PM

Document Has Been Signed on 05/18/2022 01:33 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:YERBA BUENA GARDENS CHILD DEV CTRFACILITY NUMBER:
384000406
ADMINISTRATOR:MOFAKHAM, NOUSHINFACILITY TYPE:
850
ADDRESS:790 FOLSOM STREETTELEPHONE:
(415) 820-3500
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94107
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 73DATE:
05/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Maria Roxanne ResumaTIME COMPLETED:
01:15 PM
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On May 18, 2022, Hanson Leong, a Licensing Program Analyst (LPA), conducted an unannounced annual inspection with Marie Roxanne Resuma. LPA explained the purpose of the visit to the site director. All staff members at the facility have criminal background checks on file. Thirteen teachers were observed supervising seventy-three children by the LPA. From Monday to Friday, the hours of operation are 8:00 am. to 5:30 pm.

LPA and the Director thoroughly checked the facility for potential health and safety hazards. Toys, furniture, and learning materials are all age appropriate in all classrooms. The furniture and outdoor play structures appeared to be in excellent condition. Rubberized mats surround the outdoor play structure, absorbing any accidental falls. Children are provided resting mats and cots to use while napping. There are no bodies of water on the property. All cleaning products, poisons, and other hazardous chemicals have been kept out of reach of children. The facility has a smoke detector, a carbon monoxide detector, a fully charged fire extinguisher, a centralized smoke alarm, and working telephones. According to the director, there are no firearms or weapons in the facility.

LPA observed that the facility posted the required documents.
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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2022
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: YERBA BUENA GARDENS CHILD DEV CTR
FACILITY NUMBER: 384000406
VISIT DATE: 05/18/2022
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(i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

During the inspection, LPA reviewed the children's records. All required forms were in the children’s file. The program uses an electronic app, for authorized individuals to sign their children in and out. A catering company provides food to the children at the facility.

A review of the facility's records revealed that the names, addresses, and phone numbers of each child's authorized representative are kept on file. A review of staff records revealed that all staff members have current CPR and First Aid certifications.

According to the Director, the Center simulates fire and earthquake drills monthly.

Licensee 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.



Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.
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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
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: YERBA BUENA GARDENS CHILD DEV CTR
FACILITY NUMBER: 384000406
VISIT DATE: 05/18/2022
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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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA encouraged the Director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

LPA reviewed the new director's credentials and supporting documentation. Following a final review, Jennifer Breeden, the new director, is determined to meet the department's requirements for a director by the LPA.

The site director was given both the “Notice of Site Visit” document and the Annual Inspection Report

A notice of site visit must remain posted for 30 days.

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

Exit interview conducted, and report reviewed with the site director, Marie Roxanne Resuma

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
LIC809 (FAS) - (06/04)
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