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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001489
Report Date: 09/20/2023
Date Signed: 09/20/2023 11:37:05 AM

Document Has Been Signed on 09/20/2023 11:37 AM - 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:KAI MING HEAD START-NORTH BEACH CENTERFACILITY NUMBER:
384001489
ADMINISTRATOR:LEE, NESANNAFACILITY TYPE:
850
ADDRESS:1170 COLUMBUS AVENUETELEPHONE:
(415) 931-1088
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94133
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 20DATE:
09/20/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Susanna LeungTIME COMPLETED:
11:37 AM
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On September 20, 2023, Licensing Program Analyst (LPA) Sheran Lo conducted an announced case management inspection today. LPA met with the Director Susanna Leung. The purpose of the inspection was explained to her. Present were Director, 11 staff with 20 children in care.

Facility is requesting to update License to operate with 16 toddlers ages 18-36 months and 20 children ages 2 years to entry into first grade. Today, the toddler classrooms were observed to be safe and free of hazards and have separating shelves for two groups of 8 children on each side. Preschool classroom will operate with 20 children. Facility uses a rotation schedule for children to use outdoor space. Director informed LPA that Fire Marshal has been conducted on September 18, 2023 and approved toddler classrooms. LPA will update License to the new requested capacity and age group. Updated License will be ordered when our office receives STD 850 for fire clearance.

Exit interview was conducted with Director Susanna Leung and report was provided.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Sheran Lo
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2023
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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