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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504635
Report Date: 02/06/2020
Date Signed: 02/06/2020 04:36:44 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: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:
02/06/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Kam Ming KwongTIME COMPLETED:
05:05 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced required annual inspection. LPA also conducted an increased inspection on 11/14/19. LPA met with the licensee, Kam Ming Kwong, her husband and her mother. All adults have fingerprint clearance. The purpose of the inspection was explained to her. There were 5 children included 3 infants present. The children were napping during the inspection. Per licensee, there was no new child enrolling to her daycare since the inspection on 11/14/19. She still provided the daycare service to the same children 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. Licensee and her husband who works as a helper already completed the Child Abuse Mandated Reporter Training (AB1207). The copy of the certificates were submitted to CCL in December 2019. LPA also discussed with licensee about the protocol to prevent the Coronavirus for her daycare during the inspection. Per licensee, she will create it to protect her daycare children as soon as possible.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. 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: 02/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020
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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