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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001657
Report Date: 10/11/2022
Date Signed: 10/11/2022 11:18:47 AM


Document Has Been Signed on 10/11/2022 11:18 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:LEE, HELENFACILITY NUMBER:
384001657
ADMINISTRATOR:LEE, HELENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 632-7873
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:14CENSUS: DATE:
10/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Helen LeeTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Helen Lee. The purpose of the inspection was explained to her. There was a child present. According to the licensee, most of her daycare children moved on to preschool before September. She had a new enrollment for the new school year. The licensee owned and lived in the 2 stories single-family house with her husband. The Daycare area was on the ground level including, a large playroom, a bathroom, and a backyard. Per the licensee, she closed the backyard for the daycare temporarily. She has taken the children to the public park nearby instead. The off-limit areas were the entire second floor and the storage area, the front office on the ground floor, and a garage. LPA inspected the facility for health and safety hazards. The facility was clean and in order. The temperature and lighting were adequate. There were plenty of age-appropriate toys, books, learning materials, and playhouses. slides, ride-on-toys, and children's furniture that were in good condition and repair. There were working smoke and carbon monoxide detectors, a fully charged 2A10BC fire extinguisher, and first Aid supplies available in the facility. All the sharp corners and electrical outlets were covered. All the toxins and harmful objects were made inaccessible to the children. The children's bathroom was clean and in order. There were no harmful objects in the bathroom. High chairs were available for feeding only. Cots were used for napping. Per the licensee, the children brought their food to the daycare daily. The licensee had some cubbies available for the children to store their personal belongings by the main entrance. Per the licensee, she had no guns, no weapons, and no pets in the house. The licensee had current CPR/First Aid training that will expire in 8/2024. LPA reviewed the children's files and obtained a copy of the children's roster from the licensee during the inspection. Per the licensee, her daycare child was not on special medication.
LPA discussed the safe sleep regulations with the licensee [or facility representative] 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 the licensee [facility representative] 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.
This report and notice of the 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 the 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: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2022
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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