Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002881
Report Date: 07/12/2019
Date Signed: 07/12/2019 12:32:17 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:PFS-BAYSHORE MISSION STREET CDC (INFANT)FACILITY NUMBER:
414002881
ADMINISTRATOR:TORRES, ANNFACILITY TYPE:
830
ADDRESS:7222 MISSION STREETTELEPHONE:
(650) 758-0743
CITY:DALY CITYSTATE: CAZIP CODE:
94014
CAPACITY:23CENSUS: 15DATE:
07/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Ann TorresTIME COMPLETED:
01:00 PM
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#1 Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the site director, Ann Torres. The purpose of the inspection was explained to her. There were 15 children with 8 staff with 1 Foster Grandparent present. The facility is a combination center with Preschool and Infant programs. The operation hours are Monday to Friday from 7am to 5:45 pm. There is a gate with code in the back of the building that is used by the parents for drop off and pick up. The infant program is run in 3 rooms (Toddler, Infant, and Wobblies). Outdoor play yard waiver was granted. LPA inspected the facility for health and safety hazard. The center was clean and in order. Temperature and lighting were adequate. All toxins items were either locked or made inaccessible to children. Infant room is for the infants who are not yet mobile. Wobblies room is for the children who are still under the age of 2 years old but who are mobile. The center provides food through a company called REVOLUTION which supply breakfast, lunch, and snacks. Facility also provides formula and baby food to younger children. There were plenty of age appropriate toys, books, and learning material for children to play and interact with. There was a diaper changing station within arms-length of a sink in the bathroom area. Cribs with child's name were made available for the infants to nap in the nap room. The nap room was inspected during the inspection. Mats were provided to the older children for napping. Facility provides the beddings and washes them on every Friday. Parents just provide the blankets. Drinking water was available from water fountain or tap in each classroom. All electrical outlets were covered. All sharp corners were covered. There was a separate bathroom for staff in the center. Isolation area for sick children is in the director office and the bathrooms for the adult are located outside the classroom in the main hallway. The outside play yard for the infant children was inspected. The outdoor play yard was completely fenced. There were plenty of age-appropriated toys, little tricycles, and small climbing structure available for children. The play yard had soft rubber padding that encompasses the whole play yard. At least one staff had current CPR/First Aid training, it will expire in 3/2021. The latest drill was conducted in 5/2019. All required postings were posted. Sign in/out sheets were reviewed during the inspection. Children files were reviewed during the inspection as well. Children roster was reviewed and a copy of it was obtained by the LPA during the inspection. Staff met required staff immunization and Mandated Report Training. Per Ann, there was no child on special medication. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
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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