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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002757
Report Date: 06/13/2024
Date Signed: 06/13/2024 11:56:52 AM


Document Has Been Signed on 06/13/2024 11:56 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:SF TIKES ACADEMYFACILITY NUMBER:
384002757
ADMINISTRATOR:SHIMKUNAS, SARAHFACILITY TYPE:
850
ADDRESS:1218 SOUTH VAN NESS AVENUETELEPHONE:
(415) 826-8222
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:117CENSUS: 56DATE:
06/13/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Sarah ShimkunasTIME COMPLETED:
10:25 AM
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On 6/13/2024 at 8:25AM., Licensing Program Analyst (LPA) Luis Gomez met with Director, Sarah Shimkunas. The purpose of today’s inspection was explained was for an unannounced, case management inspection to add a second toddler classroom (Cat) to existing preschool-toddler program. Existing toddler classroom is located in the Grasshoppers Classroom. Present during inspection was the director and 10 staff supervising 56 children. Children present had been properly signed in. Combination center's day and hours of operation are Monday - Friday, 8:30AM- 5:00PM. LPA inspected facility and measured indoor space.

Indoor: The 'Cat' classroom was measured and had a total square footage of 518.08. Cat classroom was equipped with 1 sink. Per director, plans are to set up several potty chairs and one diaper changing table, within arm’s reach of a sink along the wall. Furniture inspected was in like-new condition and free of splitters or sharp corners. LPA observed storage cubbies for children's belongings. Classrooms had adequately ventilated, lighting, and was comfortable temperature.

Prior to recommendation for approval toddler classroom (Cat), facility will complete the following:

-Receive Approved Fire Clearance (STD850)


-Board Resolution and /or meeting minutes approving toddler classroom
-Submit LIC309
-Submit Updated Parent Handbook
-Submit Updated Admission Agreement / Written Permission
-Submit Updated Job Description for Toddler Staff
-Submit Director’s Proof of Qualification
-Completed measurement of the new toddler classroom's encumbered space
-Finish setting up of classroom furniture, supplies, and materials

>No deficiencies were cited according to the Title 22, Division 12, Chapter 1 of Ca. Code of Regulations.

Copy of report will be sent to director. Signed copy of report will be stored in the facility file.

SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2024
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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