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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001352
Report Date: 05/07/2019
Date Signed: 05/07/2019 03:12:48 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:LIANG, JOANN JIAN YINGFACILITY NUMBER:
384001352
ADMINISTRATOR:LIANG, JOANN J. Y.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 333-2638
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 11DATE:
05/07/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Joann J. Y. LiangTIME COMPLETED:
03:30 PM
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1, Licensing Program Analyst (LPA) Yee conducted an annual random inspection today. Present at the facility are licensee, Joann, her husband, mother-in-law and 11 napping children. The facility summary report was reviewed with Joann and she said it's correct. Current residents are Joann, her husband, their daughter, Mother in law, brother and sister in law. Areas used for daycare located on the lower level. Day-care areas: living room, activity areas, bedroom for napping only, bathroom in the kitchen areas, kitchen and back yard. The entire upper level is off limit. The home is equipped with a smoke detector, carbon monoxide, and fire extinguisher. CPR & 1st aid is current until 4/2020. Required staff immunization is on file. LPA discussed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/. The certificate is on file. Childcare insurance is current and on file. SIDS "A Child Care Provider's Guide to Safe Sleep" information is provided. This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies and reviewed children's, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 102417. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, Available at http://www.ada.gov/childqanda.htm
A written IMS plan was obtained today.

website for forms: www.ccld.ca.gov. Title 22, Div 12, Chp 3
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019
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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