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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004192
Report Date: 10/06/2021
Date Signed: 10/06/2021 02:29:50 PM

Document Has Been Signed on 10/06/2021 02:29 PM - It Cannot Be Edited

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:L'ACADEMY PRESCHOOL SF NOB HILLFACILITY NUMBER:
384004192
ADMINISTRATOR:ALAMURU, PADMAFACILITY TYPE:
850
ADDRESS:1868 VAN NESS AVENUE UNIT1TELEPHONE:
(415) 361-1879
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY: 34TOTAL ENROLLED CHILDREN: 0CENSUS: 9DATE:
10/06/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Helena Geng TIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Haydee Caliboso met with Helena Geng and for an announced case management inspection. The facility requested to add toddler component program ages 18 months to 36 months to the existing childcare licensed.

LPA toured the proposed classroom, which is set up for childcare. Existing areas on the licenses, indoor and outdoor, were observed to be clean and safe. The main preschool classroom is divided into preschool classrooms and a toddler classroom. The Toddlers Classroom is physically separated from the preschool classroom using a shelf and is gated. Toddler classroom was measured and inspected today for health and safety hazards. Indoor space measures 244.05 square feet, allowing for a capacity of 6 toddler children. See facility sketch and capacity worksheet in file. There is a working refrigerator to store children’s food and a working microwave. The existing classroom has a bathroom with 2 toilets and 3 sinks inside the classroom. The bathroom is clean and with no health and safety hazards. All cleaning supplies, hazardous items are stored in a locked cabinet made inaccessible to children.

Based on available square footage, sinks, and toilets, LPA Haydee Caliboso will recommend licensure of 6 toddler children. The following is required prior to approval of 6 toddler children:

· Electrical wiring under the sink is made inaccessible to children.

No deficiencies were observed today. Notice of site visit was observed to be posted and shall remain posted for 30 days.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Haydee R Caliboso
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2021
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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