Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000062
Report Date: 08/25/2015 12:00:00 AM
Date Signed 08/25/2015 05:56:08 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:GLO AT ALICE FONG YU ALTERNATIVE SCHOOLFACILITY NUMBER:
384000062
ADMINISTRATOR:HUI-TAUNTON, STEPHANIEFACILITY TYPE:
840
ADDRESS:1541 - 12TH AVENUETELEPHONE:
(415) 753-1113
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:140CENSUS: 119DATE:
08/25/2015
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Kalok (Melinda) ChongTIME COMPLETED:
06:00 PM
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LPA Ng conducted an unannounced comprehensive required visit. LPA met with Kalok Chong, New Site Director during the visit. Facility is an school age program center. Rooms 101,102, 105, 201, 203, and 207 are used for the program. There were 119 children with 10 staff members. The center operates on the Alice Fong Yu Elementary school site. Sign in and out was inspected and reviewed and found to be accurate with full signatures. Furniture and equipment are age appropriate and in good repair. There is adequate heating, lighting and ventilation. Drinking water is readily available via water fountains and there is sufficient storage available for the children's belongings and sufficient space for the group size being served. There are separate toilet and sinks available for staff & children. Proper staffing ratios are maintained. Toilets flush. Faucets work. Toilets and sinks are reachable by children. Toilet paper, soap and towels are available and the bathrooms are clean. There is sufficient lighting and ventilation. Hot water was turned off. The school provides an afternoon snack to the children who attend the afternoon program and a breakfast for the children in the morning program. The food is prepared on site. There is a food prep area, the food was inspected for freshness and all items were in compliance. The menu is posted. There are ample activities for children. The facility has an outdoor area. The outdoor area has a play structure, the structure was observed to be in good condition. The flooring material is of soft rubber matting and concrete. Site Director states medications may be dispensed if a parent provides note and also is a prescription no over the counters. Emergency medication is stored in locked back packs in the classrooms with regular prescriptions being stored in the office. Children are only checked if there is a known illness or infestation. There are first aid supplies and thermometer available. There are Earthquake emergency items available. Isolation is provided in the office with the use of the staff bathroom if needed. Children's and Staff's records were reviewed; All of the children's records were complete. Facility has posted the required forms (i.e. License, menus, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). Staff persons are current with EMSA certified First Aid/CPR certification expiring 08/04/17. Site Director states Fire and Earthquake drills are done each month with the last one conducted on 03/17/15. In regards to discipline, positive reinforcement is used, as well as working with the parents and ultimately leading to possible termination from the program. This report was reviewed and discussed with the Dir
SUPERVISOR'S NAME: Suzanne Roman-ClarkTELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Tony NgTELEPHONE: 650-266-8843
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2015
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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