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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004601
Report Date: 08/10/2022
Date Signed: 08/10/2022 12:07:13 PM

Document Has Been Signed on 08/10/2022 12:07 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:SFUSD-GEORGE WASHINGTON CARVER ELEMENTARY SCHOOLFACILITY NUMBER:
384004601
ADMINISTRATOR:LEWIS, CATHERINEFACILITY TYPE:
850
ADDRESS:1360 OAKDALE AVENUETELEPHONE:
(415) 330-1540
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 0DATE:
08/10/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:57 AM
MET WITH:Kristy OuyangTIME COMPLETED:
11:43 AM
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On August 10, 2022, Licensing Program Analyst (LPA) Sheran Lo met with applicant Kristy Ouyang for a scheduled Relocation Pre-Licensing Inspection. The applicant is requesting 144 children (ages 2 years to entry into first grade). The facility will operate Monday-Friday; 7:45AM to 5:45PM. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.

Indoor: There are six classrooms that will be used for the program and the following square footage was calculated for the rooms. Total useable indoor square footage is 5,140 sq ft divided by 35 sq ft equals 146 children. Bungalow two will used for Gross Motor Activities. The indoor space for children is observed today to be clean. There are 16 toilets (240 capacity) and 14 sinks (210 capacity) accessible for children’s use. Bathrooms are located in the hallways. The bathrooms were observed to be clean and no health and safety hazards. Sinks accessible to children deliver water that is no warmer than 120 degrees.

Outdoor: The outdoor area measures 6,400 sq ft allowing for a total of 85 children. The outdoor area to be used is enclosed by at least a four-foot fence and observed to be clean and safe. Structure, building walls, and tarps will provide shade. Facility will use rotation schedule for the outdoor space.

LPA Lo will recommend licensure of this facility for a capacity of 144 children once the following is received:



-FIRE CLEARANCE (STD 850)

-Provide photos of classroom set up

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Sheran Lo
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
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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