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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004510
Report Date: 11/16/2021
Date Signed: 11/16/2021 12:24:22 PM

Document Has Been Signed on 11/16/2021 12:24 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:L'ACADEMY PRESCHOOL SF NOB HILLFACILITY NUMBER:
384004510
ADMINISTRATOR:ALAMURU, PADMAFACILITY TYPE:
830
ADDRESS:1868 VAN NESS AVENUE UNIT 1TELEPHONE:
(415) 706-2559
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
11/16/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Helena Geng/Padma AlamuruTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Glenn Schnell met with applicant Helena Geng and Director Padma Alamuru today for a pre-licensing inspection. This inspection included a technical assistance inspection for COVID-19 guidance and support. The applicant is requesting 8 infants (ages 12 months old to two years old). The program primarily plans to serve infants over the age of 12 months old and who are no longer in need of a crib for napping since the applicant does not have cribs for use at this location. The infant program will be part of a combination center as the applicant has an existing preschool license for 34 children (ages two years old to entry into first grade). The applicant has also submitted an application to reduce the capacity of the preschool (from 34 to 26) due to the addition of the infant program. The infant center plans to operate Monday - Friday; 8:30 AM to 5:30 PM. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Glenn A Schnell
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2021
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: L'ACADEMY PRESCHOOL SF NOB HILL
FACILITY NUMBER: 384004510
VISIT DATE: 11/16/2021
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Indoor Infants: The applicant has converted the toddler option room into the Infant Center. The total useable square footage of the room is 290.287 square feet. There is a separate nap area in front of the room and the square footage of this 69.283 - this is encumbered space that will not count in the total square footage and has already been deducted from the total space of 290.287 square feet. The maximum capacity for the infant room with regards to indoor space is 8 children.
The classroom is observed today to be clean and equipped with fire extinguisher, smoke and carbon monoxide detectors, cubbies for infants personal belongings, a separate nap area, cots for older infants, at least one changing table per room within arms reach of a sink, and age appropriate toys and equipment for infants. The program primarily plans to serve infants over the age of 12 months old and who are no longer in need of a crib for napping. At this time, the program will have three cribs available for when children enrolled still require the use of a crib. Applicant was reminded that emergency exits must be clear at all times and cots and cribs shall not be placed in a manner that blocks emergency exits. There is storage for infants personal belongings, bedding and other items provided by the parents for the care of individual infants. Parents will provide disposable diapers and wipes for their infants. There is a kitchen next to the infant room for food/drink and medication storage. Food is prepared at the facility (2 snacks and a lunch). Foods will be properly labeled with the child's name and date. The kitchen has a refrigerator/freezer, sink, and storage for dry foods. Applicant was reminded that cleaning products and other chemicals are not to be stored with foods.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Glenn A Schnell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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: L'ACADEMY PRESCHOOL SF NOB HILL
FACILITY NUMBER: 384004510
VISIT DATE: 11/16/2021
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During COVID-19, the facility will use any disposable plates, cups and utensils when necessary, otherwise other utensils and equipment used for food preparation will be sanitized in accordance with the local health department requirements. Parents will provide bottles/nipples and any other food service items for their own individual infants and the staff will ensure these items are sent home with the infants each day.

Napping equipment for older infant children developmentally too old for a crib will be a cot with proper linens and linens will be provided by parents. The napping equipment and linens will be laundered daily. Drinking water for the children will be provided by plastic baby water bottles or cups with lids provided by the parents. Medications for infants will be stored in the classroom in the office in a locked box in the refrigerator. The diaper changing area and sink cannot be used for food preparation or as a counter to store classroom activities or teacher resources. All furnishing and equipment is observed to be safe and in good condition. There are garbage cans with tight fitting lids. There are 3 sinks in the infant classroom for children's usage. There is a bathroom for children with 2 toilets and urinal in the infant room for potty training children. This bathroom is also used by the preschool program. All sinks accessible to children deliver water no warmer than 120 degrees. There is a separate bathroom for staff. The isolation room for ill infant will be in the office in the front of the building.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Glenn A Schnell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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: L'ACADEMY PRESCHOOL SF NOB HILL
FACILITY NUMBER: 384004510
VISIT DATE: 11/16/2021
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Outdoor Infants: The facility has an outdoor space currently licensed for use by the existing preschool program. The outdoor measurements are 1335 square feet which equals a capacity of 18 children. The Infant program will share the preschool playground and follow a rotation schedule to all children have adequate outdoor play time, weather permitting. A waiver will be needed for this and the applicant has submitted a request for a waiver and a rotation schedule. There is adequate share for the children, and drinking water will be made accessible to children directly on the outdoor space while they are playing outside. The outdoor space has no equipment since the landlord does not allow equipment to be stored and kept on the outdoor space. Staff also take children on neighborhood walks and to the local park.

The following items were reviewed as part of today's visit: Record keeping for staff, children and facility records, maintaining and updating needs and service plans for infants, Care and Supervision of the Children, Child Discipline Procedures- talking and redirection will be used, Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements (Safe Sleep and SIDS discussed), Completion of Individual Infant Sleeping Plans and supervision of napping infants, Food Service for Infants, Transportation-none provided, Parents Rights, and Reporting Requirements. Applicant will ensure all require postings are displayed and visible to children’s authorized representatives at all times.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Glenn A Schnell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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: L'ACADEMY PRESCHOOL SF NOB HILL
FACILITY NUMBER: 384004510
VISIT DATE: 11/16/2021
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The requirement for the testing of lead in the water was discussed (H&S Code 1597.16). LPA informed the director/applicant 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. Advisory Note provided to applicants stating that the requirement for testing must be met by January 2023.
The facility will conduct monthly disaster drills and a log will be maintained for review upon request. The fire inspection approval (11/12/21) for capacity of 8 has been received.
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 Director/Applicant, Helena Geng. Today’s report, 11/16/21, will be sent to Helena Geng at helena@lacademy.co by close of business, 11/16/21.
LPA Schnell will recommend licensure of this infant program for a capacity of 8 children effective 11/16/21.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Glenn A Schnell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
LIC809 (FAS) - (06/04)
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