Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002299
Report Date: 08/06/2019
Date Signed: 08/06/2019 04:52:00 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:C5 CHILDREN'S SCHOOL-SFPUC (PS)FACILITY NUMBER:
384002299
ADMINISTRATOR:WISEMAN, JOSEPHFACILITY TYPE:
850
ADDRESS:525 GOLDEN GATE AVENUETELEPHONE:
(415) 626-4880
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY:45CENSUS: 30DATE:
08/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Sheran LoTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Faye Bremer and Licensing Program Manager (LPM) Alma Malig conducted an unannounced Annual inspection. LPA and LPM met with Center Director Sheran Lo and explained the purpose for this inspection.

LPA and LPM toured and inspected the center's outside play area and 2 classrooms. All required posters are posted in the lobby. Upon LPA and LPM's arrival, 30 preschoolers were observed; 14 children in the younger preschool classroom with 3 teachers, and 16 children in the older preschool classroom with 3 teachers. Center was observed to be clean and sanitary, at a comfortable temperature with proper ventilation and sufficient lighting. There were 3 toilets and 3 sinks present for children's use. All passageways are kept free and clear of obstructions or hazards. Carbon monoxide and smoke detectors were observed, and building is equipped with hardwired sprinkler system. Non-slip rugs were observed. Cots were observed to have sheet and blanket for each child. Drinking water is available to children, in the classrooms and on the playground. This facility does not have any body of water present. Disinfectants are kept inaccessible to children. Hot water temperature in children's sink tested at 106F. Outside play area was inspected and was observed to have age appropriate toys. Chefables snacks and lunch is provided to all children, and individual dietary needs are observed and met. Disaster drills are conducted and logged, last drill conducted July 31, 2019. First aid kit was observed.

A sample of staff and children's files were reviewed. Staff files reviewed have all required training and documents on file. Children's files reviewed have all required assessments, agreements, and forms signed and on file.

No deficiencies are cited on today's inspection.
Report reviewed and discussed with Sheran Lo.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye BremerTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
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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