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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004878
Report Date: 08/29/2024
Date Signed: 08/29/2024 02:22:54 PM

Document Has Been Signed on 08/29/2024 02:22 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CHINESE AMERICAN INTERNATIONAL SCHOOLFACILITY NUMBER:
384004878
ADMINISTRATOR/
DIRECTOR:		CHU HSI TSENGFACILITY TYPE:
860
ADDRESS:3250 19TH AVENUETELEPHONE:
(415) 865-6000
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94132
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: DATE:
08/29/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Applicant Jeff Bissell and DIrector Chu TsengTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 8/29/2024 at approximately 10:30am, Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Jamel Maiwandi and Licensing Program Manager (LPM) Mai Lor met with Applicant Jeff Bissell, Chief Financial Officer Steve Bajc, Director Chu Tseng, Business Officer Susan Sun, and Assitant DIrector of Preschool Anges Tong for a follow-up visit pre-licensing visit on 8/15/2024. Applicant is requesting for a preschool license to serve 120 preschool children from age two years to entry into first grade.

During this inspection, LPA and LPM inspected six classrooms, #107, #109, #111, #123, #127, #131 and observed classrooms to be clean, safe, sanitary and good repair. All toilets, sinks and drinking fountains accessible to children are functional and operable. Measurements for the six classrooms were previously measured on pre licensing report dated 08/15/24 totaling 3,749.55 square feet which did not include the multipurpose room (#130). LPA and LPM measured the multipurpose room which contains a total of 1,295.75 square feet. The total indoor activity space is 5,045.3 square feet and will accommodate the applicants request for 120 preschool children. LPA and LPM observed a sufficient amount of toys, tables, chairs, napping mats, and cubbies in each room. There is one first aid kit located in each classroom.

LPA and LPM observed the primary outdoor activity space to be under construction with a tentative completion date of 9/9/2024. The applicant was advised to inform licensing upon completion of the outdoor activity space and will need to be inspected prior to use. Due to the primary outdoor activity space under construction, the applicant has created a temporary outdoor space within the courtyard area. The outdoor space is fenced with a chain link fence that is at lease 4 feet tall. The outdoor area was inspected and observed to be clean, safe, sanitary and good repair. Applicant was reminded to ensure health and safety, and supervision at all time when using the temporary outdoor space due to surrounding active construction. LPA and LPM observed a variety of sufficient age-appropriate toys and equipment. Shade is supplied by canopies and awnings.

(Report continue on subsequent LIC 809)
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CHINESE AMERICAN INTERNATIONAL SCHOOL
FACILITY NUMBER: 384004878
VISIT DATE: 08/29/2024
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The temporary outdoor space measured 7,065.87 square feet which will not accommodate the requesting capacity of 120 children. The applicant stated they will submit an insufficient outdoor waiver to stagger two groups of no more than 94 children at a time to ensure that all children have access to outdoor activity space.

The following items are required prior to a license will be issued:

1. Fire clearance
2. Insufficient outdoor waiver request with no more than 94 children at a time.

Due to technical difficulties, LIC 809 report will be emailed to Director Chu Tseng.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC809 (FAS) - (06/04)
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