384004434-6-20-2024-05-CC-JGIL-D6ETYB-20240620150828

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004434
Report Date: 06/20/2024
Date Signed: 06/20/2024 03:08:35 PM

Document Has Been Signed on 06/20/2024 03:08 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NOE VALLEY KIDS		FACILITY NUMBER:	384004434
ADMINISTRATOR/ DIRECTOR:	LISI LEI, PARIS		FACILITY TYPE:	830
ADDRESS:	3800 22ND STREET		TELEPHONE:	(415) 619-2293
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94114
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 32	CENSUS: 24	DATE:	06/20/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:27 PM
MET WITH:	Lisi Lei Paris		TIME VISIT/ INSPECTION COMPLETED:	03:40 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	On June 20, 2024, at approximately 12:30 PM, Licensing Program Analyst (LPA) Janet Gil conducted an unannounced, annual inspection. LPA met with director, Lisi Lei Paris and explained the purpose of the inspection. Present during LPA's inspection included 24 enrolled children, director, and nine staff. All staff members working in center are fingerprint cleared. Center currently operates Monday through Friday 7:30 AM to 6:00 PM. Program consists of one classroom, children's bathroom, and off limit staff bathroom and storage closet. The facility is an infant program with an attached toddler component. There were 4 infants and 20 toddler children supervised by nine staff. At approximately 1:00 PM, LPA, and director inspected facility indoors for health and safety hazards. Facility has a working telephone, fully stocked first aid kit, and two fire extinguishers on site in classroom. Entire facility has a smoke and fire alarm system implemented. LPA observed cleaning solutions, poisons and other chemicals are stored inaccessible to children in off-limit staff bathroom. Per director, facility has two enrolled children with allergies. One Child is allergic to eggs and one is allergic to nuts. Both children have an epi-pen for a allergies and they are documented on the wall for staff to see. Epi-pens are located in an inaccessible area to children and kept in children's personal cubbies. Storage for children's belongings are located inside classroom. Storage areas are labeled with each child's individual names. Classroom has age-appropriate furniture and materials that are in working condition. Classroom has proper temperature and is properly ventilated. LPA observed classroom to have one accessible children's sink. The bathroom is located on the back left of the classroom and has three accessible sinks and three toilets. All accessible sinks are free of poisons or hazardous materials. LPA observed bathroom to be clean and in proper working condition. Children's items are properly stored in individual cubbies. Drinking water is available to children indoors with children's individual drinking bottles from a non-contaminated fixture. Continue on Page 2....

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Janet Gil
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOE VALLEY KIDS	FACILITY NUMBER: 384004434
	VISIT DATE: 06/20/2024

NARRATIVE

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LPA observed changing tables, and the diaper changing tables have thick padding, covered with disposable paper, and sides raised to a minimum of 3". The changing tables are within arm's reach of the sink, and disposable wipes are used to clean after each use. There is sufficient sleeping equipment, cribs, and cots for each child. Mats and bedding are appropriately stored. The formula parents provide stored appropriately in the refrigerator, and each bottle is labeled. Parents provide formula, food, and diapers for their children. LPA observed that the food prep area was clean and organized. Per Director, the toddler playroom classroom is partitioned into two separate areas. Teachers wash Sheets weekly.

LPA observed center to use bright wheel sign in/out system. Classroom has license and all other required documents posted and visible for the public. Facility conducts drills every 6 months. Last conducted disaster drill was on 06/13/2024. The facility currently has an outdoor waiver that allows the Center to utilize the Noe Valley Courts park located at 798 Douglass St. San Francisco, which is 0.6 miles away from the facility. The facility's outdoor playground is enclosed and gated with a fence approximately 4 ft. tall. Children will walk to the park. Teachers will bring children's water bottles for playground use.

LPA reviewed 5 children's files and 9 staff files. Children's and staff files were complete with a record of emergency identification information on file. Director has a valid CPR/First Aid certificate that will expire 08/2025. All staff also have proof of required immunization that were made available for review. Mandated Reporter Training Certificates are also on file for each staff.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

The Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on al files except one(S2). LPAs encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Janet Gil
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOE VALLEY KIDS	FACILITY NUMBER: 384004434
	VISIT DATE: 06/20/2024

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Facility failed to test for lead water before January 1st, 2023. Type B deficiency is being issued on this day in accordance with the California Code of Regulations, Title 22, see LIC 809D.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with director, Lisi Lei Paris.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Janet Gil
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/20/2024 03:08 PM - It Cannot Be Edited

Created By: Janet Gil On 06/20/2024 at 02:51 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOE VALLEY KIDS	FACILITY NUMBER: 384004434
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in not testing for lead water before the due date of January 1st 2023 which posed a potential health, safety or personal rights risk to persons in care. Facility tested for lead on 10/20/2023.
	POC Due Date: 06/20/2024
	Plan of Correction
1 2 3 4	Facility tested for lead on 10/20/2023. All results were under 5.5 pbb.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Garfield Leung

LICENSING EVALUATOR NAME:

Janet Gil

LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

LIC809 (FAS) - (06/04)

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