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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001093
Report Date: 02/15/2024
Date Signed: 02/15/2024 05:39:15 PM

Document Has Been Signed on 02/15/2024 05:39 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: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: 2DATE:
02/15/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Lynette, JonesTIME COMPLETED:
05:50 PM
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On February 15, 2024, approximately 8.40am, Licensing Program Analysts (LPAs) Mok and Tso met with the Director, Lynette Jones, Executive Director, Sister Betty Dunkel and Facility Manager, Tarl Leonard, for an unannounced required annual inspection and case management for decrease in capacity. The purpose of the inspection was explained. This is an infant Center that is licensed for a total capacity of 39. Today, there are 2 infants supervised by 2 staff. The facility complies with the required teacher-infant ratios today. The hours of operation are Monday to Friday, 8:30 am to 5:30 pm.

On January 19, 2024, the Director applied for a change in capacity. This infant center is currently licensed on the first level of the building including the classroom, the nap room, and the outdoor space next to the nap room, and 5 classrooms on the second floor. Due to the Fire Department prohibiting using of the five classrooms on the second floor to provide care to the infant. Only the 2 classrooms (#118 and #123, and #125 as the napping room) on the ground floor are used for taking care of children.

The 2 new classrooms (#118 & #123) and a napping room (#125) were inspected today for health and safety hazards. No apparent hazards were observed during today's visit. During the visit, the Fire Marshal, arrived at the facility at approximately 10.30am. The indoor infant space to be on the license measures as follows:

· Classroom # 118: 791 squares feet (4 sinks and 2 toilet bowls, 1 sink for adult washing for diaper change), allowing for a capacity of 22 children aged 18-24 months.
· Classroom #123: 311.021 square feet, allowing for a capacity of 8 children aged from newborn to less than 18 months.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/15/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: EPIPHANY PARENT-CHILD CENTER
FACILITY NUMBER: 384001093
VISIT DATE: 02/15/2024
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According to the pre-licensing visit report dated 3/12/2008, outdoor Infant play space measures at 649.5 square feet allowing a capacity of 8 children, will allow 24 children with an outdoor space waiver. The facility has obtained the said waiver.

The Fire Clearance request was sent to the Fire Marshal during visit today. Fire clearance was obtained today to allow the maximum capacity of 30.

There are separate toilets and sinks for staff use. The isolation area for ill child is in the director's office. The maximum capacity facility that could be licensed for today is 22+8=30.

Once Classroom #118 is licensed, the children in care will be moved to Classroom #118 from the temporary classroom.

A copy of today’s report was given to the Director. Notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Lynette Jones.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC809 (FAS) - (06/04)
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