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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001750
Report Date: 12/08/2023
Date Signed: 12/08/2023 04:45:09 PM


Document Has Been Signed on 12/08/2023 04:45 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:LAU, CHUK SHANFACILITY NUMBER:
384001750
ADMINISTRATOR:LAU, CHUK SHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 713-3838
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY:14CENSUS: 9DATE:
12/08/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Chuk Shan LauTIME COMPLETED:
05:00 PM
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On December 8, 2023., Licensing Program Analyst (LPA) Van conducted a required inspection and met the Licensee, Chuk Shan Lau. LPA explained the purpose of the inspection to the Licensee and was given access to the property. The Licensee and two helpers supervised nine children today: three infants and six preschoolers. All adults living and working in the home have a criminal record clearance. The physical layout of the property remained unchanged, with the same off-limits and childcare areas. Childcare areas are only on the ground floor, including the playroom/classroom, two bathrooms, and the backyard. Off-limit areas are the entire second floor and the garage. All off-limits areas have been appropriately blocked off from the children. The hours of the operation are Monday to Friday, 8:30 am - 5:30 PM.

The Licensee's childcare areas were inspected and evaluated by LPA for any potential health and safety concerns. The childcare areas were clean and organized, with age-appropriate activities such as imaginary and manipulative play. The childcare areas have proper heating, lighting, and ventilation, and no defects or situations that could endanger children in care were detected. The facility had a fully charged fire extinguisher with a minimum standard of 2A 10 BC, smoke and carbon monoxide detectors, and a functional phone. All detergents and cleaning agents were kept in the bathroom cabinets with child-proof locks. Per the Licensee, no firearms, weapons, or pets were on the premises, and no baby walkers, bouncers, or similar equipment were used in the daycare. The Licensee was informed that smoking is prohibited in family childcare facilities. The backyard was observed to be completely fenced. There are age-appropriate toys and play structures. Soft cushions were installed to break any accidental fall.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2023
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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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: LAU, CHUK SHAN
FACILITY NUMBER: 384001750
VISIT DATE: 12/08/2023
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During the visit, LPA reviewed and discussed the Safe Sleep Regulation with the Licensee. The Licensee was reminded by LPA of specific guidelines that must be followed when it comes to playpens and cribs. Specifically, it is advised not to keep toys, blankets, or pillows inside or any objects hanging above the cribs/playpens. The mattresses should be designed specifically for the cribs/playpens, and bed sheets must be tightly fitted. LPA also informed the Licensee that checking on the infant every 15 minutes during naptime is mandatory. It is necessary to document these checks and keep them in the infant's file for review by the Department.

Random children's records were reviewed. The licensee maintains accurate records for each child, including vaccination records, parental rights forms, and complete emergency information. These emergency documents contain information such as the child's full name, phone number, and the location of a parent or authorized person who may be contacted in an emergency. The records also contain the name and phone number of the child's doctor and the parent's permission for the licensee to consent to emergency medical care if needed.

It has been determined that the licensee and helpers comply with all the necessary licensing requirements, including completing the required immunizations, maintaining valid Pediatric CPR/First Aid certification, and up-to-date mandated reporter training. Additionally, all the required documentation, such as the facility license, Notification of Parental Rights, Earthquake Preparedness Checklist, and Notification of Personal Rights, have been posted in a noticeable area. Per the Licensee, regular fire and earthquake drills are conducted monthly, with the latest drills completed on 12/5/2023.

LPA discussed the safe sleep regulations with the Licensees and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
LIC809 (FAS) - (06/04)
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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: LAU, CHUK SHAN
FACILITY NUMBER: 384001750
VISIT DATE: 12/08/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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 Centers and the ADA, available at: www.ada.gov/childqanda.htm.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
LIC809 (FAS) - (06/04)
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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: LAU, CHUK SHAN
FACILITY NUMBER: 384001750
VISIT DATE: 12/08/2023
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE, CHUK SHAN LAU, confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

Licensee Chuk Shan Lau read and signed the report. During today's inspection, no deficiencies were observed. Today's report and site visit notice were provided to the Licensee. LPA informed the Licensee that a site visit notification must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
LIC809 (FAS) - (06/04)
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