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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004581
Report Date: 10/27/2022
Date Signed: 10/27/2022 04:16:19 PM

Document Has Been Signed on 10/27/2022 04:16 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:NEW JOURNEY MANDARIN IMMERSIONFACILITY NUMBER:
384004581
ADMINISTRATOR:LIN, XUE YANFACILITY TYPE:
850
ADDRESS:1278A 20TH AVENUETELEPHONE:
(415) 670-0996
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 0DATE:
10/27/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Xue Yan LinTIME COMPLETED:
03:00 PM
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On October 27, 2022 at approximately 1:30pm, Licensing Program Analyst (LPA) Winnie Ly conducted an Unannounced Case Management to add a toddler component to existing license Visit at and met with Site Director Xue Yan Lin during the visit. Facility was closed upon LPA arrival. Director arrived at facility 15 minutes after LPA reached out to Director. Purpose of the inspection was explained.

Fire Clearance has been granted by the San Francisco Fire Department for facility to have 12 toddlers and 28 preschoolers.

During today's visit LPA measured the facility for the toddler program. The indoor space for the toddler measured with a total 426 square feet which can hold 12 toddlers as requested. LPA also measure the preschool program. The indoor space for the preschoolers has a total of 1012.4 square feet which can hold 28 preschoolers. LPA observed 4 toilets and 4 sinks.

Out door space has a total of 382.93 square feet which can hold 5 children outdoor. The facility currently has outdoor space waiver for preschoolers that is located at 573 Martin Luther King Jr Dr, San Francisco, CA. 94122 which is two blocks away.

Prior to licensure to add toddler component:
1. Designated toddler bathroom is required.
2. Rotational Outdoor space waiver is required.
3. Barrier must be added at the end of the stairs leading up to upstair level in the backyard.
4.Garbage cans must be clear out in outdoor area.
5. Appropriate outdoor equipment must be added for outdoor area.

A copy of this report were discussed and left with Director whose signature on this form confirm receipt of the report. Notice of Site Visit was posted. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2022
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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