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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001488
Report Date: 08/06/2021
Date Signed: 08/06/2021 03:27:14 PM

Document Has Been Signed on 08/06/2021 03:27 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:SFUSD - SHERIDAN EARLY EDUCATION SCHOOLFACILITY NUMBER:
384001488
ADMINISTRATOR:DINA EDWARDSFACILITY TYPE:
850
ADDRESS:431 CAPITOL AVENUE, ROOM130TELEPHONE:
(415) 469-4743
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 48TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/06/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Kristy OuyangTIME COMPLETED:
04:00 PM
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Licensing Program Analyst, LPA Yee met with Kristy Ouyang for a pre-licensing inspection today. The facility is licensed for 48 children and has requested an increase in capacity to serve 56 children (includes 4 nonambulatory), adding room 127. One new bathroom was added in between rooms 127 and 128. Days and hours of operation: Monday - Friday, 7:55 am - 3:30 pm. The outdoor play area is fully fenced and the yard is adjacent to classrooms 126-130.

Today LPA measured room 127 and room 128 for health and safety hazards. Room 127 space measures 758 square feet. Room 128 measures 784 square feet. No apparent hazards were observed during the inspection. Room 129 measured 708 square feet on 6/5/2014. Room 130 measured 995 square feet on 12/6/2005. There are a total of 8 sinks, and 4 toilets for preschool. Room 129 will be used as Gross Motor Room. The facility is approved for an Isolation area for the ill child is in the nurse room while calling parents for pick up.

The facility is adequately furnished with age-appropriate toys, furniture, equipment, and First Aid supplies are available. Drinking-Water is readily available. The facility will serve snacks and lunches. Earthquake/fire drills will be conducted once a month. Medications will be logged, labeled, and stored in each of the rooms in a locked box.

LPA received today: Waiver for the preschool yard.

Prior to licensure, the following items must be completed.

1) Fire clearance approval 2) General clean-up in all the rooms

website: www.ccld.ca.gov. Title 22, Div 12, Chp1.

Desk duty: Monday - Friday, 8:00 a.m. - 5:00 p.m., (650) 266-8843
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2021
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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