384001721-9-10-2024-05-CC-LGOZ-D8YVE8-20240910162156

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001721
Report Date: 09/10/2024
Date Signed: 09/10/2024 04:22:49 PM

Document Has Been Signed on 09/10/2024 04:22 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:	SFCCD-MISSION COMMUNITY COLLEGE CENTER		FACILITY NUMBER:	384001721
ADMINISTRATOR/ DIRECTOR:	MARIA VILLASANA		FACILITY TYPE:	850
ADDRESS:	1125 VALENCIA STREET		TELEPHONE:	(415) 920-6200
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 5	DATE:	09/10/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:20 PM
MET WITH:	Pilar Rendon		TIME VISIT/ INSPECTION COMPLETED:	03:30 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 9/10/2024 at 12:20PM., Licensing Program Analyst (LPA), Luis Gomez met with Lead Teacher, Pilar Rendon. The purpose of today's visit was explained and was for an unannounced, annual random inspection. This facility is licensed to operate a preschool- age program at SFCCD- Mission Campus. Per lead teacher, director is not currently on-site. Present was Lead Teacher and 2 staff supervising 4 children. Adults in facility have criminal record clearances on file. Children present had been signed-in by guardians. Days and hours of operation are Monday- Friday, 8:00-4:00PM. Preschool operated during school year, and is a 9-month program. Program utilizes three classrooms: Red Room; Rainbow Room; Blue Room/ Gross Motor Area; and the shared Napping Area; Dining Space; and Outdoor Play Area. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 12:30PM., LPA observed the following: Classrooms were clean, neat, with age-appropriate materials and playthings available for the children. Classrooms were equipped with tables, chairs, and furniture, scaled to the appropriate size. Accessible furniture was in good repair and free of sharp corners or splinters. Individual cubbies are in hallway, for storage of children’s belongings.

The children’s bathrooms were clean, with toilets and faucets in operating condition. Classroom had extra drawers and cabinets for added storage. For rest/ napping services, facility has plastic cots available. Per lead teacher, blankets and supplies are taken home weekly to be washed.

Facility had ventilation; adequate lighting; and were a comfortable temperature. Facility had a functioning telephone service and fire extinguishers (2A10BC). Per lead teacher, carbon monoxide/ smoke detectors are built into the building.

Food preparation/ storage areas were free of any liter or rubbish. LPA observed trash bins for solid waste have been covered.

At 12:40PM., Based on observations, LPA confirmed dry foods stored in facility was expired. Expired foods were removed during inspection. Advisory Note: Technical Violation (LIC9102TV) was issued. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

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 7

Document Has Been Signed on 09/10/2024 04:22 PM - It Cannot Be Edited

Created By: Luis Gomez On 09/10/2024 at 02:28 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: SFCCD-MISSION COMMUNITY COLLEGE CENTER	FACILITY NUMBER: 384001721
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	At 1:50PM., Based on record review, LPA confirmed present staff's CPR / First Aid certifications were expired. This poses a potential health and safety risk to children in care.
	POC Due Date: 09/30/2024
	Plan of Correction
1 2 3 4	Facility will submit proof of completed CPR/ First Aid Certification by the due date: 9/30/2024. Proof of correction will be submitted to the Department via email.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Luis Gomez

LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

LIC809 (FAS) - (06/04)

Page: 2 of 7

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: SFCCD-MISSION COMMUNITY COLLEGE CENTER	FACILITY NUMBER: 384001721
	VISIT DATE: 09/10/2024

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
26
27
28
29
30
31
32

(Page 2)
At 12:55PM, LPA reviewed the outside play area. Absorbent rubber had been installed on floors for added safety. Areas were completely enclosed with tall fencing and playthings were in – like-new condition. Sandbox area has been covered and was free of foreign objects. LPA reminded facility to ensure water pitchers and cup are taken outside by staff, for children to drink water as they wish.

At 1:25PM., LPA reviewed facility records including a sample of the children and personnel files. The personnel files reviewed contained Teacher's Proof of Qualifications; Immunization Record; Notice of Employee Rights (LIC9052); and Acknowledgement to Report Suspected Child Abuse (LIC9108).

LPA reminded facility to ensure staff complete require mandated reporter training course (AB1207) every two years. Advisory Note: Technical Violation (LIC9102TV) was issued.

At 1:50PM., Based on record review, LPA confirmed present staff's CPR / First Aid certifications were expired.

Children’s files were reviewed and contained the: Notification of Parent’s Rights (LIC995); Immunization Record; and Personal Rights (LIC613A).

Facility was reminded, each child's file must contain required forms including: (LIC627) Consent form for Medical Treatment, and (LIC700) Identification and Emergency Information. Advisory Note: Technical Violation (LIC9102TV) was issued.

Per lead teacher facility is conducted required emergency disaster drills every six months, with last drills (Fire/ Earthquake) completed on 8/28/2024.

Required postings in lobby and included the: Facility License; Notification of Parent’s Rights (PUB394); Personal Rights (LIC613A); The Passenger Safety Laws Form (PUB269). Emergency Disaster Plan (LIC610) was observed on file. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

LIC809 (FAS) - (06/04)

Page: 6 of 7

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: SFCCD-MISSION COMMUNITY COLLEGE CENTER	FACILITY NUMBER: 384001721
	VISIT DATE: 09/10/2024

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
26
27
28
29
30
31
32

(PAGE 3)
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations and cited on 809D. An exit interview discussing the plans for correction, facility evaluation report was conducted with Lead Teacher, Pilar Rendon. Staff’s signature on this form acknowledges receipt of these documents.

This report must be made available in facility for public review. Notice of site visit was provided and must remain posted for 30 days. Staff was advised, any additional questions/ concerns to contact the office, M-F, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

LIC809 (FAS) - (06/04)

Page: 7 of 7