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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000958
Report Date: 03/13/2024
Date Signed: 03/13/2024 12:07:19 PM

Document Has Been Signed on 03/13/2024 12:07 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:FAMILY SCHOOL CDC BERNAL GATEWAY, THEFACILITY NUMBER:
384000958
ADMINISTRATOR:HAYNES, MARILYNFACILITY TYPE:
830
ADDRESS:3101 MISSION STREETTELEPHONE:
(415) 550-4178
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 12DATE:
03/13/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Patricia BacerraTIME COMPLETED:
12:15 PM
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On 3/13/2024 at 11:20AM., Licensing Program Analyst (LPA) Luis Gomez met with Director, Patricia Bacerra. The purpose of the inspection was explained and was for an unannounced, plan of correction inspection established on 2/8/2024. Present were both director and 6 staff caring for 12 children. Staff have their criminal record clearances on file. LPA inspected facility for health and safety hazards.

During inspection, LPA conducted record review, observations, and interviews.

LPA reviewed facility records including the children files.
LPA observed staff is documenting infant napping conditions for every 15 minutes. Napping logs includes staff initials, time of review, and child's name.

Facility conducted emergency disaster drill on 2/9/2024, and was logged with the time, date and number of children present.

Deficiency issued have been cleared, and ‘Cleared Plan of Correction Letters’ were provided.

Based on today's inspection, no deficiencies were observed in the areas evaluated according to the Title 22 Division 12, Chap 1 Code of Regulations. Exit interview and report was discussed with Director, Patricia Bacerra. Signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and shall remain posted for 30 days. The licensees were advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

LPA was unable to print report during inspection. Copy of report will be sent to facility at a later date.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2024
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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