<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001308
Report Date: 12/07/2022
Date Signed: 12/07/2022 03:32:15 PM


Document Has Been Signed on 12/07/2022 03:32 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:LAM, DONG GUIFACILITY NUMBER:
384001308
ADMINISTRATOR:LAM, DONG GUI S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 290-8549
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:14CENSUS: 5DATE:
12/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Dong Gui LamTIME COMPLETED:
04:00 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
Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Dong Gui Lam and her helper who had fingerprint clearance, and explained the purpose of the inspection to her. LPA observed 5 children that included 3 infants present with the helper and licensee upon LPA's arrival. The facility was called "Dong Dong Day Care" as well. The facility's operation hours were Monday to Friday from 8:30 AM to 5:30 PM. The licensee owns this 4 story single family house, and another house behind the building within the same lot. The licensee's daughter lives and operates a licensed daycare in another house. The licensee lives in the house with her son, her son's girlfriend, and her youger daughter. All adult residents had fingerprint clearance. The Day care areas were the kitchen/dining area on the 2nd level, entire in-law on the ground level and backyard. The off-limit areas were the all the rooms, living room, bathrooms on the 2nd level and third and fourth floor. LPA inspected the facility for health and safety hazards. There were a fully charged 2A10BC fire extinguisher, working smoke detectors, and first aid supplies. There were plenty of the age appropriate toys, books, learning materials, and children's furniture that were in good condition and repair available. Mats and play pens were used for napping. Boosters were used for feeding only. All the electrical outlets were covered. All sharp corners were covered. All the lower cabinets were latched. The children's bathroom was clean. All the lower bathroom sink cabinet and drawers were free of harmful objects. All toxins and harmful objects were made inaccessible to the children in care. Per licensee, there is no pet, no firearms or no weapons in the house. Facility has conducted fire drills at lease once every six months and was properly logged. The outdoor play yard was completely fenced and clean. The licensee installed the soft cushioning to the entire ground to prevent injury. There were plenty of variety of children's toys, ride-on toys, swing and children's furniture available for children outdoors. If there were ill child, staff would separate them in the nap room while waiting for parent to pick them up. Licensee was utilizing the children's roster and it was updated. Licensee and her helpers had current pediatric CPR and First Aid training and Child Abuse Mandated Reporter Training. Facility has provided meals to children in care daily. The facility had the hand sanitizer, touchless Thermometer, and disinfectant available to prevent COVID19. LPA reviewed children's file and obtained a copy of the current children roster during the inspection. The facility has posted all required postings.

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: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022
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 1