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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004979
Report Date: 02/05/2025
Date Signed: 02/05/2025 01:51:52 PM

Document Has Been Signed on 02/05/2025 01:51 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:SF TIKES ACADEMYFACILITY NUMBER:
384004979
ADMINISTRATOR/
DIRECTOR:		SARAH SHIMKUNASFACILITY TYPE:
860
ADDRESS:1133 SOUTH VAN NESS AVENUETELEPHONE:
(415) 531-0625
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 130TOTAL ENROLLED CHILDREN: 117CENSUS: DATE:
02/05/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Applicant Kristina ItskovichTIME VISIT/
INSPECTION COMPLETED:
01:49 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Jamel Maiwandi met with applicant Kristina Itskovich for the purpose of an announced pre-licensing inspection at 1133 South Van Ness Avenue San Francisco, CA 94110 on 2/5/2025 at approximately 10:20am. This is a change of location application from 1218 South Van Ness Avenue San Francisco, CA, 94110. Applicant is requesting 93 preschool children ages 2-5 and 24 toddlers ages 18-36 months. Facility will operate Monday through Friday from 8:00am to 6:00pm. Fire clearance was granted onn1/7/2025.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

INDOOR ACTIVITY SPACE:

There are two toddler classrooms (#3,#4) and seven preschool classrooms (#1,#2,#5,#6,#7,#8, and sensory room) located in the facility. Due to facility currently undergoing active maintenance and transition, LPA took preliminary measurements in each classroom and informed applicant additional measurements will need to be taken once facility is fully set up and complete. Toddler classroom 3 and 4 contain a total of 1,027.552 square feet and Preschool classrooms 1,2,5,6,7,8 and sensory room contain a total of 3,308.485 square feet. There is a total of 8 toilets and 8 sinks available for children and two separate private restrooms for the staff. LPA observed a functional carbon monoxide detector in each classroom and in the main entrance area. The isolation area for sick children will be located in the main office area and the staff isolation area will be located in the food prep area. The food preparation area is located downstairs and is inaccessible to children. Disinfectants and cleaning solutions will be located in each bathroom in each classroom and inaccessible to children as well as in the storage room located next to the sensory room as well as a cleaning service that will come every Friday.

Report continues on LIC 809 page 2
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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: SF TIKES ACADEMY
FACILITY NUMBER: 384004979
VISIT DATE: 02/05/2025
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There will be a dedicated landline for the facility and a paper sign in and sign out system. Drinking water will be provided via filtered pitcher water and parents will provide drinking water as well. Napping cots and mats will be provided by the facility and blankets, sheets and pillows will be provided by children’s families. Medications will be stored in locked medical cabinets in each bathroom and accordingly to each individual child along with the doctor’s prescription. There will be a first aid kit located in the main office area, food prep area, and each classroom.

OUTDOOR ACTIVITY SPACE

There are two outdoor play areas located at the facility, one for toddlers and one for preschool children. Due to active maintenance, LPA took preliminary measurements in both outdoor areas and informed applicant additional measurements will need to be taken once outdoor areas are fully set up and complete. The preschool outdoor area includes a total of 1,241.34 square feet and will not accommodate the applicants request for 93 preschool children. LPA measured the toddler outdoor area which includes a total of 1,075.78 square feet and will not accommodate the applicants request for 24 toddler children. There are no bodies of water located onsite and applicant stated a sail shade will be installed to ensure adequate shade is provided in both the toddler and preschool area.

Exit interview conducted and report was reviewed with Applicant Kristina Itskovich.

The following is required before a license will be issued:

· Review of document corrections
· Facility fully set up and classrooms and outdoor areas complete
· Final measurements of classrooms and outdoor area
· Final LPM approval
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC809 (FAS) - (06/04)
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