384004459-9-21-2022-05-CC-LGOZ-CJGR3B-20220921123939

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004459
Report Date: 09/21/2022
Date Signed: 09/21/2022 12:40:27 PM

Document Has Been Signed on 09/21/2022 12:40 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PROJECT COMMOTION-LAS LUCIERNAGAS		FACILITY NUMBER:	384004459
ADMINISTRATOR:	OSTERHOFF, SUSAN		FACILITY TYPE:	850
ADDRESS:	2095 HARRISON STREET		TELEPHONE:	(415) 252-8059
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 12	CENSUS: 6	DATE:	09/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Christina Ponce, Susan Osteroff		TIME COMPLETED:	12:50 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 9/21/2022 at 8:45AM., Licensing Program Analyst (LPA), Luis J. Gomez met with Lead Teacher, Cristina Ponce. Purpose of the inspection was explained and was for an unannounced; Annual/ Random inspection. Director, Susan Osteroff arrived during inspection. Present was the lead teacher and three staff supervising six children. All staff have criminal record clearances on file. Children present have been signed in. Preschool program utilizes one classroom; indoor multi-purpose/ gross motor space; and one outdoor play area. Day and hours of operation are Monday- Thursday, 8:30AM- 3:30PM and Friday, 8:30AM- 1:30PM. LPA inspected facility, indoors and outdoors, for health and safety hazards. At 9:00AM., LPA observed the following: Facility was clean, orderly, with age-appropriate playthings available for the children. Floors and ground surfaces were free of obstructions. Accessible furniture, tumbling mats, and materials inspected were in proper repair. Entry way is equipped with labeled storage cubbies for children’s belongings. Classroom, located next to entry way, has several child sized tables and chairs. Children’s bathroom has adequate supplies for hand washing, and fixtures tested were operating condition. Staff bathroom is located separate. For napping services, stackable cots are stored in the multi-purpose/ gross motor space. Per lead teacher, napping sheets are washed weekly by staff. Classroom and gross motor space have acceptable ventilation and lighting. Detergents; cleaning supplies; compounds; and toxins are stored in the off-limit area. Electrical outlets, heater vents, and trash bin are covered. Classrooms had functioning smoke/ carbon monoxide detector combo; and two (fully charged) fire extinguishers; 2A:10BC. Per director, detectors are build into the building. First aid kit was reviewed during inspection. At 9:20AM., LPA inspected facility’s outdoor play area. Outdoor area is completely enclosed with tall fencing. Available seating and a shaded rest area is accessible for the children. Play Area free of debris or hazardous plants or objects. Per lead teacher, water services are provided with use of refillable water bottles, brought outside by staff. LPA reminded facility to ensure all children water bottles are labeled with the corresponding child’s name. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

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: PROJECT COMMOTION-LAS LUCIERNAGAS	FACILITY NUMBER: 384004459
	VISIT DATE: 09/21/2022

NARRATIVE

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(Page 2)
Facility’s food prep area was reviewed during inspection. Area was made inaccessible with child safety gate. Food items inspected were current and properly stored.

At 9:45AM, LPA reviewed the facility records including six children’s files and five personnel files. Staff files reviewed included the: Notice of Employee Rights (LIC9052); Criminal Record Statement; Proof of Qualifications; and Declaration to Report Suspected Child Abuse (LIC9108);

At 9:50AM., Based on record review, LPA confirmed proof of required immunization are not in the facility files. Advisory Note: Technical Assistance (LIC9102TA) was issued during inspection.

LPA reminded director to ensure staff’s ‘Mandated Reporter Training’ certificates (AB1207) are stored in the facility files.

Children’s files were reviewed and included signed: Consent for Medical Treatment (LIC627); Identification of Emergency Information (LIC700); Health History (LIC702); Immunization Records; and Notification of Parent’s Rights (LIC995).

Staff’s Cardiopulmonary Resuscitation / First Aid certification was current, expiring: 2/18/2023. Disaster drills are conducted in facility every six months, with the last drill done on, 8/23/2022, properly logged.

Required forms and posted in facility, including the Childcare License; Outdoor Space Waiver; Child Passenger Safety Laws; Notification of Parent’s Rights (PUB393); Emergency Disaster Plan (LIC610); and Updated Menu (September). Children’s medication was reviewed and incident medical services were discussed.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
(REFER TO 809C FOR CONT.)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: PROJECT COMMOTION-LAS LUCIERNAGAS	FACILITY NUMBER: 384004459
	VISIT DATE: 09/21/2022

NARRATIVE

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Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview and report was reviewed with Director, Susan Osteroff and signature of this form acknowledges receipt of these documents.

This report and appeal right and rights were discussed. This report must be available in the facility for public review. Notice of site visit was provided and must remain posted for 30 days. Any additional questions facility was advised to call Regional Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

LIC809 (FAS) - (06/04)

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