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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004498
Report Date: 10/28/2021
Date Signed: 10/28/2021 02:48:46 PM

Document Has Been Signed on 10/28/2021 02:48 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:SOMA DAYCARE & PRESCHOOLFACILITY NUMBER:
384004498
ADMINISTRATOR:LUI, MEIXINFACILITY TYPE:
850
ADDRESS:473 BRYANT STREETTELEPHONE:
(415) 418-4834
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94107
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/28/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ngoc LuongTIME COMPLETED:
03:30 PM
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Licensing Program Analysts (LPAs) Glenn Schnell and Jyoti Saini met with Applicant Ngoc Luong today for a pre-licensing inspection. This inspection included a technical assistance inspection for COVID-19 guidance and support. The applicant submitted a change of location application. The applicant is requesting 30 children (ages 2 years to entry into first grade) and of the 30 children, the applicant wants 6 of the slots to be dedicated to a toddler option component (children ages 18 months to 3 years old). The facility will operate Monday - Friday; 8:00 AM to 5:30 PM. The designated director/site supervisor for the facility is Meixin Lui. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.
Indoor: The Facility consists of 2 classrooms on the first floor and a multipurpose room which is located at second floor. The following square footage was calculated for each room: Room 1(Toddler) 369.276 sq ft. , Room 2 (Preschool) 458.037 sq ft., Room 3 (Multipurpose room) 613.852 sq ft. Total useable indoor square footage is 1441.165 sq ft divided by 35 sq ft equals 41 children. The indoor space for children is observed today to be clean and all furnishing, toys and equipment observed to be safe and in good condition. There is storage space for children's personal belongings and mats to be utilized for napping children. Parents will provide a sheet and blanket for their child, bedding will sent home to be laundered weekly. Cots will be cleaned daily or more often if needed. Children will be signed in and out by parents with electronic signature. The indoor space is equipped with a fire extinguishers, smoke and carbon monoxide detectors, garbage cans with tight-fitting lids, and a first aid kit. The facility is adequately ventilated and free of insects and bugs. The program provides two snacks daily and parents will provide lunch.
Report continues on the next page.
SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2021
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: SOMA DAYCARE & PRESCHOOL
FACILITY NUMBER: 384004498
VISIT DATE: 10/28/2021
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Medications will be stored in the high cabinet in the classroom #2 inaccessible to the children. There are 2 toilets (30 capacity) and 3 sinks (45 capacity) accessible for children's use. The bathroom for children is located inside the preschool classroom. The bathroom was observed to be clean and with no health and safety hazards. Sinks accessible to children deliver water that is no warmer than 120 degrees. Children will also bring their own individual water bottles. All toxins and other hazardous items will be stored in a locked cabinet in the classroom and will be inaccessible to children. Isolation of ill children will be located the director’s office and staff bathroom will be used for an ill child.
Outdoor: The facility does not have an outdoor space. The applicant is in the process of obtaining a permit through the San Francisco City Parks and Recreation Department to use Circle South Park public playground, approximately one block from the facility. Until the applicant can obtain the proper permit from the City, the staff will plan to take the children in daily walks of groups no larger than eight children. The applicant has a written safety protocol in place for taking neighborhood walks. This was reviewed with the applicant today and is on file in the facility file at San Bruno Child Care Regional Office.
The applicant has submitted a formal waiver request for an open space waiver. This was reviewed during the inspection today and LPA's walked to the park to conduct an inspection of the location to be considered for use; Circle South Park public playground, located at 64 South Park Avenue, San Francisco, CA 94105.

The toddler option children will share a bathroom, toilet and sink, with the preschool classroom. Applicant understands that preschool and toddler option children cannot commingle in the bathroom at any time.The applicant understands that the children must be kept physically separate from the preschool age children. The applicant was advised that the parents permission is needed if the child moves out of the toddler option program before the age of 3.

Report continues on the next page
SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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: SOMA DAYCARE & PRESCHOOL
FACILITY NUMBER: 384004498
VISIT DATE: 10/28/2021
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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 talk with the children and use redirection, Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service-Program provides two snacks and Parents provide lunch, Transportation-none provided, Parents Rights, and Reporting Requirements. Required postings were observed during today's inspection. Facility will conduct disaster drills and a log will be maintained for review upon request. The fire inspection was conducted, and approved. The requirement for the testing of lead in the water was discussed (H&S Code 1597.16). LPA informed the director/licensee to review Provider Information Notice 21-21-CCP (dated 7/28/21) for directives and regulations regarding obtaining a test of the water for lead, and how that information is to be documented and reported to Community Care Licensing. Requirement for testing must be met by January 2023.
Since the applicant will have a toddler option component, LPA Schnell discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Applicant was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Report continues on the next page

SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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: SOMA DAYCARE & PRESCHOOL
FACILITY NUMBER: 384004498
VISIT DATE: 10/28/2021
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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

LPA Schnell reviewed the COVID-19 self assessment guide and required postings with the applicant today. Applicant was informed that access to available Personal Protective Equipment (PPE) may be available through the local child care resource and referral agency.

Report was reviewed and signed by Applicant, Ngoc Luong. Today’s report, 10/28/21, will be sent to Ngoc at info@somadaycare.com by close of business, 10/28/21. Confirmation of receipt is required.
SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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: SOMA DAYCARE & PRESCHOOL
FACILITY NUMBER: 384004498
VISIT DATE: 10/28/2021
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LPA Schnell will recommend a provisional license at this time, effective 10/28/21, of this facility for a capacity of 30 children, with 6 being toddler option age. The provisional license will be valid for 90 days and expire on 1/28/2022. During the provisional license period, the applicant agrees to submit the following application documents and satisfy the remaining application requirements no later than 30 days prior to the expiration of the provisional license:
  • Obtain Park Permit from San Francisco Parks and Recreation Department for the waiver request regarding the open space waiver
  • Monthly Operating statement( LIC 401)
  • Balance Sheet ( LIC 403)
  • Verification of Director Qualifications: EMSA Certified Preventative Health Practices, Pesticides training ( no older than 1 year), and EMSA certified Lead Poison Training
  • Personnel Policies
  • Parents Handbook
  • Discipline Policies
  • Admission Policies
SUPERVISORS NAME: Alma Malig
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5