Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002637
Report Date: 02/07/2018
Date Signed 02/07/2018 11:11:05 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:SFUSD-JOSE ORTEGA ES (EED) PSFACILITY NUMBER:
384002637
ADMINISTRATOR:JOLYNN T. WASHINGTONFACILITY TYPE:
850
ADDRESS:400 SARGENT ST, RM 001 & B-8TELEPHONE:
(415) 750-8505
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94132
CAPACITY:48CENSUS: 28DATE:
02/07/2018
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Alma AlbertoTIME COMPLETED:
11:30 AM
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LPA Yee conducted a follow up inspection today. Present at the facility were 28 children and 5 staff member. Today LPA reviewed staff required immunization. Citation cited on 11/28/17 has been corrected.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2018
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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