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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504635
Report Date: 11/14/2019
Date Signed: 11/14/2019 04:24:30 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:KWONG, KAM MINGFACILITY NUMBER:
380504635
ADMINISTRATOR:KWONG, KAM MINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 387-7187
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:12CENSUS: 5DATE:
11/14/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Kam Ming KwongTIME COMPLETED:
04:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mok conducted an unannounced increased inspection. LPA met with the licensee, Kam Ming Kwong, and her helpers who have fingerprint clearance. The purpose of the inspection was explained to them. There were 5 children included 3 infants present. The children were napping during the inspection. Licensee owns this 2 story single family house. Licensee lives in the house with her husband, her mother, and her sister. All adults have fingerprint clearance. The facility operation hours are Monday to Friday from 7:30am to 6:00pm. The daycare areas are the entire mid-level, and a deck in the back of the house. The off-limit areas are the entire lower and upper levels. LPA toured and inspected the facility for health and safety hazard. The house was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. There were plenty of the age appropriate toys, books, learning material, and children’s furniture available in the daycare. There were a fully charged 2A10BC fire extinguisher, and first Aid supplies available in the daycare. Smoke and carbon monoxide detector were not tested because the children were napping during the inspection, Fireplace was blocked by a cabinet. Gates were used at the main entrance, kitchen entrances, stairway, & dining room entrance. Window locks were installed to the windows to limit the windows to be opened up to 4 inches in the living room. Cribs were used for napping. High chairs were available for feeding only. All electrical outlets were covered. Diaper changing table was available in the dining area. All lower cabinets in the dining area were locked or free of dangerous items. All the lower kitchen cabinets and drawers were latched or free of dangerous items. Children’s bathroom was clean and free of harmful object. Carpet was installed to the entire play areas to prevent injury. The deck in the back of the house was clean. There was a play house available for the children. Licensee provides breakfast, AM/PM snacks, and lunch to the daycare children. Per licensee, there were no children on special medication. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care facilities and the ADA, available at: http://www.ada.gov/childqanda.htm. Licensee had current CPR/First Aid training, it will expire in 8/2020. Children file and roster were reviewed during the inspection. LPA also obtained a copy of the roster during the inspection. Fire and disaster drills are conducted quarterly. The latest drill was conducted on 9/12/19. Licensee and helpers have required staff immunization.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. A Child Care Provider's Guide to Safe Sleep was provided to licensee during inspection. Notice of site visit was provided. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
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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