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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004134
Report Date: 08/05/2019
Date Signed: 08/09/2019 10:43:45 AM

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:GOLDEN GATE KINDERCARE LEARNING CENTERFACILITY NUMBER:
384004134
ADMINISTRATOR:HEMBERGER, EMILYFACILITY TYPE:
850
ADDRESS:334 28TH AVENUETELEPHONE:
(415) 760-5794
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:94CENSUS: DATE:
08/05/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Emily HembergerTIME COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA) Pandora Huffman-Smith met with the applicant today for a pre-licensing inspection. Also present today is the current owner, 9 teachers, 6 additional staff, and 41 children. This inspection is for a change of ownership and the applicant is requesting the same capacity as the prior owner (94). The facility will operate Monday-Friday from 7:00 AM to 6:00 PM. The facility was inspected today, indoor and outdoor, for health and safety hazards.

Indoor: The facility operates in eight classrooms; A level, C level, B west, B east, D west, D east, E level and the music room. All classrooms appear to be clean and equipped with fire extinguishers, smoke and carbon monoxide detectors, children's cubbies, first aid and emergency supplies, napping equipment, and toys and equipment for children. All furnishing and equipment appear to be safe and in good condition. There are two bathrooms that are equipped with 3 toilets and 3 sinks, 4 bathrooms equipped with 2 toilets each and there are 2 sinks in each of the classrooms D east and E level. Total toilets for children's usage is 14 and sinks is 10. All bathrooms appear to be clean and no apparent health and safety risks were observed. The facility kitchen appears to be clean and all equipment appears to be in good condition.

Outdoor: The outdoor play area is separated into three sections. All areas appear to be clean and all toys and equipment appears to be safe and in good condition. There is sufficient cushioning underneath the play structure.

This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area where the medication and equipment/supplies will be stored. 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
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Pandora Huffman-SmithTELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019
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 2
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: GOLDEN GATE KINDERCARE LEARNING CENTER
FACILITY NUMBER: 384004134
VISIT DATE: 08/05/2019
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A fire inspection has been conducted, approved. and was received in the San Bruno Regional Office on July 5, 2019.

Requirements prior to licensure:
  2. LIC 999, Facility Sketch, is required for the lower level of the facility.
  3. Board resolution authorizing the applicant to act on behalf of the board.
  4. All facility postings listed below need to be updated.
    • PUB 393 (Parent's Rights Poster)
    • LIC 613 (Personal Rights)
    • PUB 269 (Car Seat Law) including phone number for the local health department
    • LIC 9148 (Earthquake Preparedness Checklist)
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Pandora Huffman-SmithTELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019
LIC809 (FAS) - (06/04)
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