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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000561
Report Date: 06/27/2019
Date Signed: 06/27/2019 01:33:36 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:LIAO, XIAO LINGFACILITY NUMBER:
384000561
ADMINISTRATOR:LIAO, XIAO LINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 330-9968
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:14CENSUS: 12DATE:
06/27/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Xiao Ling LiaoTIME COMPLETED:
02:00 PM
NARRATIVE
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#2 Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met the licensee, Liao Xiao Ling and her helpers who have fingerprint clearance. The purpose of the inspection was explained to her. There were 12 children with 2 helpers present upon LPA arrival. Licensee owns this 2 stories single family house. Licensee lives in the house with her husband and her 2 children. All adult residences have fingerprint clearance. The daycare operation hours are Monday through Friday from 8:00 am to 6:00 pm. The daycare area is located on the lower level. Children enter from the side gate on the lower level of the facility. A camera doorbell system was installed at the gate. The Daycare areas are the entire lower level of the house & backyard. The Off-limits areas are the entire upstairs, garage and the storage room downstairs. LPA inspected the facility for health and safety hazard. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to daycare children. There were plenty of age-appropriate toys, books, learning material, and children’s furniture available for children. The Children’s furniture was in good condition. There was the fully charged 2A10BC fire extinguisher, working home telephone, working 2 in 1 smoke & carbon monoxide detector, and first aid supplies available at daycare. Licensee also installed carpet and soft cushioning to the entire floor in the daycare areas to prevent injury except for bathroom areas. Boosters were available for feeding only. Cots were used for napping. Cubbies were available for children to store their own belongings. Children’s bathroom was clean and free of hazard. All lower kitchen cabinets were latched. Gates were used between kitchen and hallway, and stairway to upper level. There was a door between the kitchen and play area. Childproof knobs were installed on the doors. All electrical outlets were covered. All sharp corners were covered. The facility provides breakfast, AM/PM snacks, lunch and dinner to daycare children. Per licensee, there are no guns, no weapons, and no pets at home. The outdoor play area was completely fenced. Licensee has installed carpet to the entire ground at the play area to prevent injury. There was no harmful object observed in the play area during the inspection. There were plenty of age-appropriate toys, playhouses, and ride-on-toys available to children. Disaster drill has been conducted monthly. The latest drill was conducted in 5/2019. Licensee and helpers have current CPR/First Aid Training; they will expire in 5/2021. 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. Children files and current roster were reviewed during the inspection. LPA also obtained a copy of the roster from licensee during the inspection. All staff have met the required staff immunization. Licensee and her helpers had completed the Mandated Reporter Training. The certificates were reviewed during the inspection. All required postings were posted.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For a 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: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019
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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