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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002032
Report Date: 02/03/2020
Date Signed: 02/03/2020 02:45:41 PM

COMPREHENSIVE INSPECTION
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:LI, GUI PINGFACILITY NUMBER:
384002032
ADMINISTRATOR:LI, GUI PINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 586-8977
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 9DATE:
02/03/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Gui Ping Li, GuiFang Cao, Peiyi TongTIME COMPLETED:
03:00 PM
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3, Licensing Program Analyst, LPA Yee conducted an annual random inspection today. There are 9 napping children, licensee, Gui Ping Li, one helper, and Gui Ping's daughter present today. The purpose of the inspection was explained. Current residents at the facility are Gui Ping, her husband, and their son. No change in the daycare areas as previously licensed. Day-care areas (downstairs level) only: living room, bedroom, kitchen, bathroom, and backyard. The entire upper level and garage areas are off-limit. The staff has current CPR & 1st aid certificate until 5/2020. The home is equipped with a smoke detector, a carbon monoxide detector, and a fully charged fire extinguisher. The facility provides morning snacks, afternoon snacks, and lunches. 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 is on file. The licensee has child abuse mandated reporter training, AB1207 certificate on file. The helper needs to take AB1207. Licensee's daughter said helper is waiting for the Chinese version to become available. She is also aware that the helper may take the class from the approved outside vendor for a small fee. The training needs to be renewed once every 2 years.
Child Abuse Mandated Reporter Training, AB1207. www.mandatedreporterca.com. Last fire drill, and emergency drill was conducted on January-2020. Children's files were reviewed. The licensee competed the roster during the inspection.

Website: www.ccld.ca.gov. Title 22, Div 12, Chp 3

Office: Monday - Friday, 8:00 a.m. - 5:00 p.m. (650) 266-8800
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
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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