384000990-3-7-2023-05-CC-JYEE-CPPQVD-20230307113010

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000990
Report Date: 03/07/2023
Date Signed: 03/07/2023 11:30:44 AM

Document Has Been Signed on 03/07/2023 11:30 AM - 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	LIU, YAN LI & LI, JINGJING		FACILITY NUMBER:	384000990
ADMINISTRATOR:	LIU, YAN LI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 333-6028
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94112
CAPACITY:	14	CENSUS: 9	DATE:	03/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Yan Li Liu, JingJing Li		TIME COMPLETED:	11:45 AM

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	Licensing Program Analyst (LPA) Yee conducted an Unannounced Required - 1 Year inspection today. The purpose of the inspection was explained. LPA met with Yan Li, JingJing, 1 hepler, and 9 children. Residents at the facility are Yan Li, her husband, JingJing, JingJing's husband, and JingJing's 2 year old daughter. The facility personnel summary report was reviewed with JingJing and current.. The facility operation hours are Monday - Friday, 7:00 am - 6:00 pm. Daycare areas (lower level): living room, dining room bathroom, bedroom #1, and backyard. The remaining areas of the home are off-limits. The home is clean orderly and properly ventilated. The home is equipped with a fully charged fire extinguisher size 2A10BC, a smoke detectors, and a carbon monoxide. Smoke detector and carbon monoxide are in working condition. There are no swimming pool or hot tub in the premises. All harmful objects such as sharp, chemicals, detergents, cleaning compounds, medication are made inaccessible to children in care. Kitchen/Bathroom cabinets/drawers have child protective locks in place making all sharp objects, toxic, cleaning products, household items are inaccessible to children. First aid supplies are available for children. The last fire/emergency drill was conducted on 2/2/23. The disciplinary policy was discussed with Licensee today. The home has age-appropriate toys and equipment available for the children in care. LPA reviewed the children's records and the staff records. Both children, staff records are incomplete. LPA reminded JingJing to keep the records current. She said she understands. JingJing CPR, 1st aid is current until 3/2024. Yan Liu's CPR, 1st Aid is not available during the visit. She said she took the class last year and unable to locate at this moment. She will submit her CPR, 1st aid to CCL by the end of next week. continue to the next page.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: LIU, YAN LI & LI, JINGJING	FACILITY NUMBER: 384000990
	VISIT DATE: 03/07/2023

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
26
27
28
29
30
31
32

LPA discussed Child Abuse Mandated Reporter Training AB1207 with Licensee. As of January 1, 2018, all staff will be required to complete Child Abuse Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. AB1207 was completed on 3-25-22.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, an updated Plan of Operation that includes 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 Centers and the ADA, Available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with the licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Notice of Site Visit posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2