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Department of
SOCIAL SERVICES

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001885
Report Date: 11/05/2015
Date Signed 11/05/2015 01:28:55 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:	SFSU - CHILDREN'S CAMPUS (INFANT)		FACILITY NUMBER:	384001885
ADMINISTRATOR:	WEISS, MARJORIE		FACILITY TYPE:	830
ADDRESS:	NORTH STATE DRIVE		TELEPHONE:	(415) 405-4011
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94132
CAPACITY:	36	CENSUS: 30	DATE:	11/05/2015
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Majorie Weiss and Anna Tobin-Wallis		TIME COMPLETED:	01:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	PA Ng conducted an unannounced annual random visit to the facility at issue. LPA met with Majorie Weiss, Site Director and Anna Tobin-Wallis. Facility is an infant program center. Rooms 118 and 121 are used for the infants and rooms 119 and 120 are used for the toddler program. There were a total of 30 infants and toddlers with a total of 9 staff members. Director states that there are no guns or weapons present in the facility. CLASSROOMS: Furniture and equipment are age appropriate and in good repair, cribs have been replaced in 2012 . There is adequate heating, lighting and ventilation. Drinking water is readily available via service by staff via pitchers and drinking cups , 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. There are sufficient cribs and cots for each child. Proper staffing ratios are maintained. BATHROOMS AND TOILETING AREAS: 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 tested at above 120 degrees F. but the plumbers were working on the hot water system during the inspection the plumbers claimed that the adjustment was complete and would take some time to lower in temperature. The director was advised to place signage to warn of the extremely hot water. INSPECTION OF FOOD SERVICE AREA: The parents provides the formula and the infants eat on demand. For the toddler program the school provides 2 snacks to the children and parents provide the lunch for their child. The snacks are prepared on site, there is a food prep kitchen area in each of the classrooms, the food was inspected for freshness & all items were in compliance. The menu is posted, all drinking apparatuses were properly labeled. INSPECTION OF OUTDOOR PLAY AREA: There are ample toys and activities for children. The facility has 2 outdoor areas. The outdoor areas has small play structures and several large sand pits. The pits were tarped and the structures were observed to be in good condition. The flooring material is of soft rubber matting and artificial turf. Water service in the outside area is via drinking fountains.

SUPERVISOR'S NAME: Suzanne Roman-Clark	TELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Tony Ng	TELEPHONE: 650-266-8843
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2015

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2015

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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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: SFSU - CHILDREN'S CAMPUS (INFANT)	FACILITY NUMBER: 384001885
	VISIT DATE: 11/05/2015

NARRATIVE

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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 each of the classrooms in the upper cabinets in a lock box. Director states that children are greeted and checked for illness. There are first aid supplies and a thermometer is available. Director states that there are Earthquake emergency items available. Isolation is provided in the office with the use of the staff bathroom if needed.
RECORDS: Facility has posted the required forms (i.e. License, menus, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law (updated), and Emergency Disaster Plan). Staff persons are current with First Aid/CPR certification expiring 06/12/17. Site Director states Fire and Earthquake drills are done each month and the last logged event was on 10/14/15.
DISCIPLINE POLICY: Director states that social emotional skills development, talking and redirection as well as prevention is used as discipline..
DEFICIENCIES: None observed.

SUPERVISOR'S NAME: Suzanne Roman-Clark	TELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Tony Ng	TELEPHONE: 650-266-8843
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2015

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2015

LIC809 (FAS) - (06/04)

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