384004308-12-3-2021-05-CC-HRCO-C9CPYP-20211203104413

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004308
Report Date: 12/02/2021
Date Signed: 12/03/2021 10:45:20 AM

Document Has Been Signed on 12/03/2021 10:45 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:	NORTH BEACH KIDS TOO, LLC		FACILITY NUMBER:	384004308
ADMINISTRATOR:	ANTHONY WILLIAMS		FACILITY TYPE:	830
ADDRESS:	728 BROADWAY STREET		TELEPHONE:	(415) 350-9213
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94133
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 0	DATE:	12/02/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Anthony Williams		TIME COMPLETED:	12:40 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	Licensing Program Analyst (LPA) Haydee Caliboso met with applicant Anthony Williams today for a pre-licensing inspection. The applicant has requested a combination of an infant with toddler component program. The applicant has requested 12 infants, ages birth to 18 months, and 32 toddlers, ages 18 months to 36 months. The facility plans to operate Monday - Friday; 7:00 AM to 6:00 PM. The designated Director for the facility will be Anthony Williams. The facility was inspected today, indoor and outdoor, for health and safety hazards, and was measured to calculate capacity. This inspection included a technical assistance inspection for COVID-19 guidance and support. Indoor: The facility building that will be used for the program is on the lower level of a commercial building separated into 2 buildings. The facility building has its own designated entrance. The Toddler program is located on 728 Broadway and the Infant program is located on 730 Broadway. There is one designated classroom for the infant program and one classroom for the toddler program. The infant classroom was calculated to be a total of 825.29 sq. ft., allowing for a capacity of 23 infants. Toddler classroom was calculated to be a total of 909.010 sq. ft., allowing for a capacity of 25 toddlers. The Toddler classroom is observed today to be clean and equipped with a fire extinguisher, and both smoke and carbon monoxide detectors. The facility is adequately ventilated and free of insects and bugs. The toddler classroom and furniture equipment are clean and in good condition. Children’s toys and supplies are orderly, in good condition, and age appropriate. There is storage space for children's personal belongings. The Infant classroom is still being renovated and will be kept off limits until area(s) is approved as a daycare area. The Infant area classroom has a kitchen with a built-in counter-top area, sinks available for staff and children to use, and garbage cans with tight-fitting lids. Cont. 809-C pg. 2

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

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: NORTH BEACH KIDS TOO, LLC	FACILITY NUMBER: 384004308
	VISIT DATE: 12/02/2021

NARRATIVE

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Refrigerated medications will be stored separately from food. Medication will be administered with parental consent and will be kept in the child’s file for record. All medication will be logged when administered to children. The facility has a designated kitchen area where food is prepared, a working refrigerator, and a working dishwasher where utensils are to be cleaned. The program will provide morning and afternoon snacks. The parents will provide lunch daily. The parents will provide a sheet and blanket for the children. Bedding is to be washed twice per week or as needed. Cots will be used for older infants and will be cleaned daily or as needed. The Toddler classroom has 2 toilets and 2 sinks available for children to use. The bathroom was observed to be clean and with no health or safety hazards.

Infant: There is storage for infants’ personal belongings. The parents will provide diapers and wipes for the infant. The parents will also provide bottles/nipples and any other food service items for each infant, and the staff will ensure breastmilk and or milk formula is served fresh daily to the infant. The infant classroom has a built-in counter-top area, with a sink which includes bottle warmers and a refrigerator. The bottle warmer is out of reach of the children. The infant classroom has a diaper changing table within arm’s reach of a sink. The Director has stated, additional cribs will be purchased as enrollment increases. Medications for infants will be stored in the classroom in high cabinets or in locked boxes in the refrigerator. Drinking water for the children will be provided by plastic baby water bottles or cups with lids provided by the program. Staff will meet and review the individual written needs and service plans quarterly with the parents. Plans will be kept in the children’s files.

There is a separate bathroom available for staff to use. The isolation area for ill children is located at the waiting area or entrance area. Staff bathroom will be used for ill children, if needed, until parents arrive for pick-up. The facility will conduct and log fire drills once every six months, and the log will be available upon request. All cleaning supplies and hazardous items are stored in a locked cabinet made inaccessible to children.

Outdoor: The outdoor area measures a total of 480 sq. ft., allowing for a total of 6 children. The program provided a request waiver for scheduled outdoor rotation usage. The facility’s outdoor playground is enclosed and gated.
Cont. 809-C pg. 3

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

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: NORTH BEACH KIDS TOO, LLC	FACILITY NUMBER: 384004308
	VISIT DATE: 12/02/2021

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The outdoor space was observed to be clean and safe. The Director stated additional outdoor toys will be purchased as enrollment increases. The program will submit a letter from the landlord for exclusive use of the outdoor space during the hours of care. The program will provide additional outdoor field trips around the neighboring area. Field trips forms are needed for each child and will be kept in file for records.

The following items were reviewed as part of today’s visit: Record keeping for staff, children, and facility records, care and supervision of the children, child discipline procedures – staff will use positive discipline and redirection. Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Safe Sleep and Individual Infant Sleeping Plan (LIC 9227), Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements were reviewed today.This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. 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

An electronic copy of this three-page report was emailed to Anthony Williams. Applicants were asked to review the report and return a signed copy of the report to LPA Haydee Caliboso. COVID-19 Self-assessment guide was received and reviewed today with the Director.

Based on available square footage, sinks, and toilets, LPA Haydee Caliboso will recommend licensure of this facility for a capacity of 44 children. The following is required prior to regular licensure:
· COVID-19 Self-Assessment Guide.
· Letter of waiver for scheduled outdoor rotation.
· Letter of approval from the Landlord for exclusive use of outdoor space during the hours of care.
· Photo of posting requirements.
· Photo of outdoor space set-up with varieties of age-appropriate toys and floor cushions are installed on the floor for infant children.
· Photo of completed fence around the bamboo plants in the outdoor play area.
· Electric unit equipment outdoor is made inaccessible to children.
· Photo of completed nap area in the infant program.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

LIC809 (FAS) - (06/04)

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