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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002038
Report Date: 03/05/2020
Date Signed: 03/05/2020 04:25:22 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:PUN, CHUNG YINFACILITY NUMBER:
384002038
ADMINISTRATOR:PUN, CHUNG YINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 831-1426
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:14CENSUS: 7DATE:
03/05/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Chung Yin Pun (Peggy)TIME COMPLETED:
04:55 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced required inspection today. LPA met with the licensee, Chung Yin Pun (Peggy) and her helper who has fingerprint clearance. There were 7 children that included 1 infant present with a helper. The operation hours of the facility are Monday to Friday from 7:30 AM to 5:30 PM. Licensee lives in the house by herself. The house has 3 bedrooms, 2 bathrooms, kitchen, living room, dining room, garage, and backyard. LPA toured and inspected the house for health and safety hazard around 3:10 PM. The house was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. There were some of the toys, books, learning material, and children’s furniture available for the children. There were a fully charged 2A10BC fire extinguisher, telephone, working smoke and carbon monoxide detector, and first aid supplies available for the children. All sharp corners were covered. Carpet and soft cushioning were installed to the floor to prevent injury. Fire place was blocked by shelve. Gate was installed between living room and dining room. Dining room was used as the napping area with play pens. Children’s bathroom was clean and free of harmful objects. The lower bathroom cabinets and drawers were free of harmful objects. Per licensee, there were no guns, no weapons and no pets in the house. Per licensee, children bring their own food and snack to the daycare daily. Licensee and her helper had current CPR/First Aid training certificates available for review during the inspection. The certificates will expire in 8/2020. Licensee and her helper have completed the Child Abuse Mandated reporter training. The certificates were reviewed during the inspection. Per licensee, there were no children on special medication. 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 facilities and the ADA, available at: http://www.ada.gov/childqanda.htm. All required postings were posted. Children’s files were reviewed during the inspection. LPA also obtained a copy of the current children roster from licensee during the inspection.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. A Child Care Provider's Guide to Safe Sleep was provided to licensee during inspection. Notice of site visit was provided. 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: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
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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