<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001093
Report Date: 01/11/2023
Date Signed: 01/11/2023 03:35:27 PM

Document Has Been Signed on 01/11/2023 03:35 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:EPIPHANY PARENT-CHILD CENTERFACILITY NUMBER:
384001093
ADMINISTRATOR:LYNETTE JONESFACILITY TYPE:
830
ADDRESS:100 MASONIC AVENUETELEPHONE:
(415) 567-8370
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 39TOTAL ENROLLED CHILDREN: 39CENSUS: DATE:
01/11/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lynette JonesTIME COMPLETED:
04:00 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
Licensing Program Analyst (LPA) Mok conducted an unannounced case management inspection today. LPA met with a Site Director, Lynette Jones, and explained the purpose of the inspection to her. There were 7 children with 3 staff present. The facility applied for adding rooms to the existing infant program without changing the capacity on 11/30/2022. The facility wanted to include the 4 rooms in a separate building with 8 rooms, a big bathroom, a small bathroom, a conference room, an office, AV & Book Room, and a Faculty room in the same property as the program. LPA inspected and conducted the measurement of the rooms due to the facility needing to touch up the rooms during the inspection. The building was a location in the back of the main building. The main entrance of the building was from O'farrell street. The four rooms the facility wanted to add were on the left side of the main entrance. The rooms were Classroom #1, #2, Nap room, and Storage. The building had a big bathroom for children with 3 sinks and 3 children's size toilets available in the building. It also had an individual bathroom for staff next to the children's bathroom.

LPA inspected the indoor space for health and safety hazards. Indoor infant space measured was 738.94 square feet, allowing for a capacity of 21 children. The rooms had not been set up for inspection yet. LPA has to conduct another case management inspection whenever the rooms are ready for the final inspection and fire clearance approval is received by CCL before licensure.







This report and notice of the site visit were discussed with the licensee and must be made available to the public upon request. For a quarterly update on Licensing information, go to the 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: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1