384003090-10-29-2025-05-CC-CQUO-DMWQB3-20251029120053

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384003090
Report Date: 10/29/2025
Date Signed: 10/29/2025 12:01:01 PM

Document Has Been Signed on 10/29/2025 12:01 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:	SFUSD-MISSION EDUCATION CENTER ELEMENTARY SCHOOL		FACILITY NUMBER:	384003090
ADMINISTRATOR/ DIRECTOR:	CARLA LLEWELYN-VASQUEZ		FACILITY TYPE:	850
ADDRESS:	1670 NOE STREET		TELEPHONE:	(415) 379-2700
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 12	CENSUS: 7	DATE:	10/29/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:40 AM
MET WITH:	Raul Chavez		TIME VISIT/ INSPECTION COMPLETED:	12:15 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 October 29, 2025 at approximately 8:40am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection to Mission Education Elementary School. LPA met with the Executive Director of Early Childhood Education, Raul Chavez, and explained the purpose of the visit. Preschool program operates at Mission Education Elementary School in classroom #102 only. Preschool program operates Monday through Friday 7:30am to 5:30pm. Present during LPA's visit included 7 preschool children with 3 teaching staff. All teaching staff are fingerprinted through the San Francisco Unified School District. With executive director, LPA inspected preschool areas, indoors and outdoors, for health and safety hazards. Preschool classroom includes toys, materials and children's equipment that are in good condition. There are carpets in the classroom that are clean, free of stains. Per executive director, there are morning and afternoon janitorial services. LPA observed children's materials and equipment to be age appropriate. Classroom includes areas for active play, quiet space, and dramatic play. Children's personal belongings are stored in the classroom, in individual cubbies. LPA observed cubbies to be labeled with children's individual names. There is a fully charged fire extinguisher, emergency backpack, fire sprinklers, fire alarm system and carbon monoxide detector in the classroom. LPA tested the carbon monoxide detector in the classroom, which was observed to be working. LPA observed cleaning solutions, poisons and chemicals to be stored in classrooms' high shelves, inaccessible to children. There is a cabinet in the classroom that was observed to have a child safety lock. LPA observed cabinets that did not have a child safety lock to not have poisonous materials stored. There is a water pipe system in the classroom that is covered and made inaccessible to children. (Continue Report on Page 2...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFUSD-MISSION EDUCATION CENTER ELEMENTARY SCHOOL	FACILITY NUMBER: 384003090
	VISIT DATE: 10/29/2025

NARRATIVE

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Preschool program have access to a restroom that is located inside the classroom. LPA observed restroom to have age appropriate toileting equipment. LPA also observed restroom to be in working condition. There are garbage bins in the classroom and in the children's restroom with tight fitting lids. There is also an accessible sink and water fountain in the classroom. Sinks accessible to children do not provide water that is warmer than 120 degrees Fahrenheit.

Preschool children sleep in the classroom on cots. LPA observed cots to be labeled with children's individual names. Sheets and blankets are provided by children's families at this time. LPA observed cots to be stored appropriately when not in use.

Preschool program utilizes shared elementary school's basketball court. LPA observed basketball court to be fully enclosed and fenced. Outdoor toys and materials are appropriately stored away when not in use. Per executive director, children have access to outdoor area twice a day. LPA did not observe any pools, spas or bodies of water on site.

Drinking water is available to preschool children, both indoors and outdoors, with children's individual water bottles that can be refilled through accessible water fountains on site.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care
Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

School district provides a food service that is prepared in the on site cafeteria. Food services includes breakfast, lunch and afternoon snack. Preschool children eat in their classroom.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFUSD-MISSION EDUCATION CENTER ELEMENTARY SCHOOL	FACILITY NUMBER: 384003090
	VISIT DATE: 10/29/2025

NARRATIVE

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Children are signed into and out of program through written, paper sheets. LPA observed sheets include the time a child is signed into and out of program and their authorized representatives' written signatures. Licensing documentation is posted directly outside the preschool classroom, available for review. Per executive director, emergency disaster drills are conducted monthly or quarterly (depending on the drill conducted). Last emergency disaster drill was conducted 10/28/2025. Isolation area for sick children is located in the principal's office that is equipped with a cot, if needed.

During today's visit, LPA reviewed six random children's files. Children's files were complete with a record of required immunizations, emergency and admission information. Per executive director, teaching staff during LPA's visit were recently hired and onboarding documentation and certificates are still being completed. LPA reviewed teaching staffs' education transcripts and observed staff to be qualified. There is at least one teaching staff present with a current CPR and First Aid certificate that was made available for LPA's review.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a
maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During today's visit, no deficiencies were issued. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Raul Chavez.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025

LIC809 (FAS) - (06/04)

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