Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410517130
Report Date: 02/04/2016
Date Signed 02/04/2016 05:14:44 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:HILLSIDE CHRISTIAN ACADEMY (SA)FACILITY NUMBER:
410517130
ADMINISTRATOR:KERRAN, LINDAFACILITY TYPE:
840
ADDRESS:1415 HILLSIDE BLVDTELEPHONE:
(650) 588-6860
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:45CENSUS: 19DATE:
02/04/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Linda KerranTIME COMPLETED:
05:25 PM
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(2) LPA Andrea Medlin met staff and site director for this random annual licensing visit today. Purpose of the visit was explained. There were 19 children present. Days and hours of operation: Monday-Friday 7:00AM-8:15AM and 2:45PM-6:00PM. Physical plant toured, including the areas used for the program, and outdoor play area to inspect for health and safety hazards. There is a fully charged fire extinguisher that meet minimum requirements, smoke detectors, and entire facility has water sprinklers. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. A separate staff bathroom is available. No pools, spas, hot tubs, fish ponds, or bodies of water are present. Per director, there are no firearms or weapons on site. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Variety of age appropriate toys and materials for children are available in the facility. Facility is set up for child care, furniture and equipment for children are available as well. First aid supplies are available. Sick children will be separated from the group and wait for parents to pick up. There are school aged outdoor play areas. The areas around and under high climbing equipment is cushioned with tanbark. Outdoor activity space surfaces are free of hazards. Center has posted all the required licensing forms (License, Notification of Parent's Rights, Notification of Personal Rights, and Emergency Disaster Plan). LPA reviewed staff and children's files. In the children's files reviewed, all children had Identification and Emergency information on file. In the staff files reviewed, all staff have current Pediatric First Aid and CPR (exp. 2/25/2016) certification; staff have documentation of the appropriate educational requirements. No apparent health and safety hazards were observed during the visit.

This report was reviewed with site director and a copy of this report must be available for public review upon request.

Notice of site visit was posted during visit and shall remain posted for 30 days.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8843
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8843
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2016
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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