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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001093
Report Date: 02/02/2023
Date Signed: 02/02/2023 12:30:15 PM

Document Has Been Signed on 02/02/2023 12:30 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
PENINSULA CHILD CARE, 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: 0DATE:
02/02/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Lynette JonesTIME COMPLETED:
01:00 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 a case management inspection to complete the room adding without changing the capacity request that the facility submitted on 11/30/22. LPA met with the Site Director, Lynette Jones, and 4 teachers. Licensee closed the facility to prepare the rooms for the prelicensing inspection, so it had no children present during the inspection. LPA completed the room measuring without any setup in the rooms on 1/11/2023, so LPA continuous to completed a final inspection of the rooms(Classroom #1 (Gross Motor Room), #2 (Main Classroom), Nap & Lunch room, and storage) with the final setup; the rooms located in a separate building on the same property. The program will share the building with other staff who have fingerprint clearance; a main entrance of the program will be on O'farrell street. LPA toured and inspected the rooms for health and safety hazards. The rooms were clean and in order; temperature and lighting were adequate; toxins and harmful objects were locked or made inaccessible to the children; all electrical outlets and sharp corners were covered. There were plenty of age-appropriate toys, books, learning materials, and children's furniture available in Rooms #1 and #2. There was a table with children's chairs and cots with the child's name and cover on each in the Nap Room. Two portable sinks set up in Room #2 next to a Diaper Changing table and outside the Nap room entrance for the children's use. The facility will refill the water in the portable sinks daily. Per Lynette, the facility will deliver the meal from the kitchen in the main building to the Nap/Lunch room daily. There was a compost bin with a tide lid for the food waste in the Nap/Lunchroom. The rooms also had a wastebasket with a tide lid. There were first aid supplies and a Thermometer available in Classroom #2. The facility keep the medication box with a lock in the storage room that was between Classroom #2 & Nap/Lunch Room. The facility had the right amount of cubbies with the child's name for the children to store their belongings outside Room #2. The children's bathroom was located across from Room #2. It had 3 toilets (one child's size and 2 adult size with a Potty training seat), 3 sinks, 2 portable potties, and a diaper changing table. The building had a staff bathroom available for the adults. The building had a water fountain available for children by the children's bathroom entrance. The daycare children will use the secured pathway with gates in the back of the building to the playground. CCL received the fire clearance for room adding on 12/6/22. LPA approved the rooms for the program as of today.

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: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2023
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