Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002241
Report Date: 05/19/2016
Date Signed 05/19/2016 11:01:13 AM

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:CCFC-VV TUCKER CENTER (P)FACILITY NUMBER:
384002241
ADMINISTRATOR:FONDA DAVIDSON, EXEC. DIR.FACILITY TYPE:
850
ADDRESS:103 TUCKER AVENUETELEPHONE:
(415) 921-7019
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:40CENSUS: 12DATE:
05/19/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Nakita ChowTIME COMPLETED:
11:25 AM
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#2 Licensing Program Analyst(LPA) Mok conducted an unannounced annual random visit this day. LPA met with a regional manager, Nakita Chow. The purpose of visit was explained to her. There were 12 children with 3 staff present. This center was closed for remodeling about 2 months. It's been re-opened since 5/11/16. Per Nakita, the center just re-opened one of the classrooms that was facing to Tucker Avenue first because another classroom was still closed for remodeling. Per Nakita, another classroom will be opened in August 2016. The center has 2 classrooms, and outdoor play area is adjacent to both classroom. The operation hours are Monday to Friday from 8:30am to 5:30pm. LPA toured the facility for health and safety hazard. The room was clean and in order. Temperature and lighting in the classroom was adequate. All required postings were posted by the classroom entrance. Sign in/out sheet was reviewed during visit. Per Nakita, facility has provided breakfast, lunch, and snacks to day care children. The food has been delivered from the central kitchen daily. There were plenty of age appropriate toys, book, learning material & furniture available. Drinking water & cups were available for children. Cots were available for napping. Outdoor play area was completely fenced. There was a play structure with soft cushioning underneath to prevent injury. Children's bathroom was clean and free of hazard. There was a staff bathroom available in classroom #2 that was located in lower level. All toxins and harmful objects were locked and made inaccessible to children. At lease one staff has current CPR/First Aid training in the center, it will expire in 9/2017. There were at least one fully charged fire extinguisher 2A10BC available in the classroom, & first aid supplies available. Medication box was kept in the upper cabinet in the classroom. It was inaccessible to children. Children's files were reviewed during visit. LPA also discussed with licensee about Immunization for staff during visit. Effective on September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she hasn't been immunized against Influenza, Pertussis, & measles. Each employee and volunteer shall receive an influenza vaccination between August 1, and December 1 of each year.

This report was reviewed and provided to regional manager. The notice of site visit was given as well.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8843
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2016
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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