384001365-3-22-2022-05-CC-ACON-CCS27P-20220322170904

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001365
Report Date: 03/22/2022
Date Signed: 03/22/2022 05:09:38 PM

Document Has Been Signed on 03/22/2022 05:09 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:	SOUTH OF MARKET CHILD CARE CENTER ON NATOMA		FACILITY NUMBER:	384001365
ADMINISTRATOR:	SMITH, LOREN		FACILITY TYPE:	850
ADDRESS:	685 NATOMA STREET		TELEPHONE:	(415) 487-0389
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 27	CENSUS: 22	DATE:	03/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:57 AM
MET WITH:	Xiaorum		TIME COMPLETED:	03:25 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	On March 22, 2022 at 11:57 AM, Licensing Program Analyst (LPA) Cowan met with Lead Teacher, Xiaoru Mo, for a 1 Year Required Inspection. Purpose of the inspection was explained. The director is not in the office this day. At 12:30 PM Operations and Compliance Analyst (OCA), Melinda Soria and Development and Enrollment Manager (DEM), Jocelynda Wi arrive to meet with LPA. Present, in the facility are 7 staff, and 22 children in care. Facility is operating within its capacity, and facility is in compliance with staff / child ratio on this day. Facility now operates day care Monday to Friday from 08:00 AM to 05:30 PM. Facility is only using two classrooms: Rose Room and Sunflower Room. LPA toured facility with lead teacher Xiaoru Mo. LPA inspected the day care rooms and play yard. LPA observed facility has smoke detector, carbon monoxide detector, fully charged fire extinguisher and working telephone on site. All cleaning solutions, poisons and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Facility floor is in good repair and free of any hazards. There are first aid supplies available in the classrooms. All bathrooms are in working condition. All storage containers for solid waste fitted lids. All food is stored properly to avoid contamination. Food preparation area is free of litter. Food is stored adequately to prevent contamination. Play yard is free of hazards. There is a sufficient amount of cushion material in the play yard to help absorb the impact of falls. There is water available on the yard as well as in the classroom. Report continues on next page………

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

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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Document Has Been Signed on 03/22/2022 05:09 PM - It Cannot Be Edited

Created By: April Cowan On 03/22/2022 at 02:06 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SOUTH OF MARKET CHILD CARE CENTER ON NATOMA	FACILITY NUMBER: 384001365
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 3 out of 7 staff files Ref# 2, 3, and 4 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/29/2022
	Plan of Correction
1 2 3 4	DEM agrees to email LPA current Mandated Reporter Trainings for Ref # 2, 3, and 4 for staff by 3-29-22.

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review,, the licensee did not comply with the section cited above in 1 out of 7 staff files Ref # 7 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/08/2022
	Plan of Correction
1 2 3 4	DEM agrees to email LPA a copy of LIC 503 Health Screening for staff member Ref # 7 by 4-8-22..

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Garfield Leung

LICENSING EVALUATOR NAME:

April Cowan

LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

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: SOUTH OF MARKET CHILD CARE CENTER ON NATOMA	FACILITY NUMBER: 384001365
	VISIT DATE: 03/22/2022

NARRATIVE

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OCA and DEM are aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

>See next page for deficiencies

Exit interview conducted and report was reviewed with OCA, Melinda Soria and DEM, Jocelynda Wi.

This report must be available in the facility for public review. Notice of site visit it to be posted for 30 days. For additional questions, call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

Copy of this report was reviewed and will be emailed to the director, Loren Smith and Jocelynda Wi at loren@somacc.org and joy@somacc.org by the close of business on 3/22/22. Confirmation of receipt is required. Signed copy of this report will be stored in the facility file.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: SOUTH OF MARKET CHILD CARE CENTER ON NATOMA	FACILITY NUMBER: 384001365
	VISIT DATE: 03/22/2022

NARRATIVE

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LPA observed that facility is using electronic sign in / out. LPA collected a print-out of sign in/out. Facility has license and all other required documents posted and visible for the public. There are menus posted at least one week in advance and are visible to the child's authorized representative. Facility’s last emergency drill was conducted 3/18/22 and is properly logged.
At 12:23 PM, LPA reviewed the facility records. LPA reviewed 10 random children's files. Children’s files are complete with all required Licensing documents. LPA reviewed 7 staff's files. At 1:32 PM, LPA observed that staff members did not have current Mandated Reporter Training on File. At 1:51 PM, LPA observed that staff member did not have Health Screening on file. These are potential risk to children in care. Type B violations are issued this day.

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. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director 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.
Report continues on next page………

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC809 (FAS) - (06/04)

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