384003090-8-26-2021-05-CC-CQUO-C69PEE-20210826111500

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384003090
Report Date: 08/26/2021
Date Signed: 08/26/2021 11:15:51 AM

Document Has Been Signed on 08/26/2021 11:15 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SFUSD-MISSION EDUCATION CENTER ELEMENTARY SCHOOL		FACILITY NUMBER:	384003090
ADMINISTRATOR:	CARLA LLEWELYN-VASQUEZ		FACILITY TYPE:	850
ADDRESS:	1670 NOE STREET, RM 102		TELEPHONE:	(415) 379-2700
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 0	CENSUS: 4	DATE:	08/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Head Teacher, Calixta Paz		TIME COMPLETED:	11:10 AM

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On August 26, 2021 at 9:00 AM, Licensing Program Analyst (LPA) Catrina Quimbo met with head teacher, Calixta Paz, for a random, annual inspection. Purpose of the inspection was explained. Present, in the facility are 3 staff, and 4 children in care. Facility is operating within its capacity and is in compliance with staff / child ratio on this day. Facility operates day care from Monday - Friday 8:00am to 3:30pm.

With Lead Teacher, LPA inspected the preschool classroom and play yard for health and safety hazards. Storage for children's belongings are in the classroom, labeled with each child's names. LPA observed facility has a carbon monoxide detector, fully charged fire extinguisher and fire alarm system implemented. Classroom has a working telephone on site. All cleaning solutions, poisons and other chemicals are stored in the classroom with a child safety lock, inaccessible to children. Facility has age appropriate furniture. There were a variety of age appropriate toys and materials available for children in care.

There are first aid supplies available in the classroom. There is one bathroom in the classroom, with one sink and one toilet. Bathroom was observed to be in good working condition with appropriate sanitation products. Program has an additional waiver for shared bathroom use, reviewed by LPA.

Facility is part of a food program. All food is stored and prepared properly to avoid contamination. Facility has a sufficient amount of sleeping mats available. Laundering and sanitization was discussed. Individual drinking bottles and other items provided by the parents are labeled and stored on each child's individual cubbies, indoors. Facility uses the separate preschool courtyard for play. Waiver was posted, available for review. There is water available for children in the courtyard at designated drinking fountains.

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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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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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: SFUSD-MISSION EDUCATION CENTER ELEMENTARY SCHOOL	FACILITY NUMBER: 384003090
	VISIT DATE: 08/26/2021

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LPA observed that facility is using paper sign in / out system. At time of inspection, all children were properly signed in to program. 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. Facility has an emergency drill log for the new school year. Next scheduled emergency drill is September 1, 2021. At 10:00 AM, LPA reviewed the facility records. LPA reviewed 2 random children's files and 1 random staff's files. Both children's files and staff's files were complete.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Head teacher is 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 certificate on file. LPA encourages the head teacher to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Incidental Medical Services (IMS) policy was discussed. Program is not providing IMS at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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: SFUSD-MISSION EDUCATION CENTER ELEMENTARY SCHOOL	FACILITY NUMBER: 384003090
	VISIT DATE: 08/26/2021

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>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.

After the inspection, an exit interview was conducted with head teacher, Calixta Paz. Report was reviewed and signed by head teacher. Today’s report, August 26, 2021 and notice of site visit will be emailed pazc1@sfusd.edu to by close of business. Head teacher was advised to acknowledge receipt of report. Head teacher was reminded that a site notice shall be posted in a prominent place in facility for 30 days during the hours of operation. Failure to maintain postings as required will result in a civil penalty of $100.

This report is public and can be reviewed. This report must be available in the facility for public review. Head teacher was advised to contact San Bruno Regional Office for any additional questions, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC809 (FAS) - (06/04)

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