Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504442
Report Date: 01/10/2018
Date Signed: 02/06/2018 02:46:43 PM

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-NORIEGA EARLY EDUCATION SCHOOL (PS)FACILITY NUMBER:
380504442
ADMINISTRATOR:NG, IVYFACILITY TYPE:
850
ADDRESS:1775 - 44TH AVENUETELEPHONE:
(415) 759-2853
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:136CENSUS: 79DATE:
01/10/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Ivy NgTIME COMPLETED:
11:30 AM
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LPA Ng conducted a random annual inspection. Present was Ivy Ng, Site Supervisor with 12 staff persons supervising 79 children in 5 classrooms. Classroom 5 was not in operation on this visit. Facility is a preschool program center. The facility operates rooms 1,2,4,5 and 6. Site Supervisor states that she has no knowledge of any guns or weapons within the facility.
CLASSROOMS: Furniture and equipment are age appropriate and in good repair. Heating, lighting and ventilation is adequate. Drinking water is available via the water fountain, there is sufficient storage available for the children's belongings and sufficient space for the group size being served. There are sufficient Cots for each child and was observed to be stored per regulations, accessories are cleaned on a weekly basis by parents. A carbon monoxide detector was observed, tested and working.
BATHROOMS AND TOILETING AREAS: There are separate toilet and sinks available for staff & children. Toilets flush, faucets work. Toilets and sinks are reachable by children. Toilet paper, soap and towels are available and the bathrooms are clean. Hot water was tested at 96 degrees F.
INSPECTION OF FOOD SERVICE AREA: The school provides a Breakfast, lunch, and 1 afternoon snack to the children. The food is prepared off site, by the school districts own facilities, there is a food prep kitchen area, the food was inspected for expiration dates and fruits for freshness. and the menu is observed to be posted.
INSPECTION OF OUTDOOR PLAY AREA: There are ample toys and activities for children. The facility has an outdoor area, there are two play yard areas each having their own structures. The large structure was inspected and observed to be in good condition. The smaller structure and yard had some fencing blown over due to a storm and is in the midst of being repaired. There is shading available and the flooring material is concrete and rubber underneath the structure.
HEALTH-RELATED SERVICES: Site Director states medications may be dispensed if a parent provides note and also is a prescription no over the counters. Medication is stored in the classrooms in locked cabinets and also locked in back pack pouches. Children will be greeted and checked for illness. There are first aid supplies and thermometer available. There are emergency items available. Isolation is provided in the office with the use of the staff bathroom if needed.
SUPERVISOR'S NAME: Suzanne Roman-ClarkTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Tony NgTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2018
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: SFUSD-NORIEGA EARLY EDUCATION SCHOOL (PS)
FACILITY NUMBER: 380504442
VISIT DATE: 01/10/2018
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FACILITY IS PROVIDING IMS: This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers, Section 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. Facility has already submitted an IMS plan through the school district. was also informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. All staff have updated required immunization record in file. Facility has one child using IMS, file was reviewed.
RECORDS: Facility has posted the required forms (i.e. License, menus, waivers, scheduling, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan, Earthquake preparedness, never shake a baby information, emergency evacuation chart). First Aid/CPR certification is current to 03/25/19 . Director states that emergency drills will be done each month with the last event logged on 12/13/17.
DISCIPLINE POLICY: Director states that positive reinforcement.
LPA also went over all new regulations with the Licensee ( IMS (ADA.gov), immunization, Toddlers, Civil penalties, smoking prohibition, Pesticides (DPR.ca.gov), and Childhood Nutrition training. LPA observed Site Director posting the Notice of Site Visit. The report was reviewed with the director and no deficiencies were observed in this visit.
ADVISORY: Director was advised to check up on maintaining the first aid supplies and to meet with staff in regards to earthquake safety.
PESTICIDES:
Pesticide regulations were discussed with the director, In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one hour online course is available on the Department of Presticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. If the director had questions she can email ccipmlist@cdpr.ca.gov.
SUPERVISOR'S NAME: Suzanne Roman-ClarkTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Tony NgTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2018
LIC809 (FAS) - (06/04)
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