<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002038
Report Date: 04/25/2022
Date Signed: 04/25/2022 03:21:18 PM


Document Has Been Signed on 04/25/2022 03:21 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
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: 6DATE:
04/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Chung Yin Pun (Peggy)TIME COMPLETED:
03:55 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Chung Yin Pun (Peggy) and her helper, Hoi Yee Lui (Brenda Lui). She used to be a FCCH's licensee at another location on the same street, but she has temporarily closed her daycare for inactive now. The purpose of the inspection was explained to them. There were 6 children with 2 staff upon LPA arrival. All adults were fingerprinted. The facility's operation hours were Monday to Friday from 7:30AM to 5:30PM. The licensee rents this Single family house with 3 bedrooms, 2 bathrooms, kitchen, living room, dining room, garage, and backyard. The daycare areas were the living room, dining room, and a front room with an adjacent bathroom that next to the living room. The off-limit areas were the entire upper and lower level,kitchen, garage, and backyard. LPA toured and inspected the house for health and safety hazards. 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. The window in the dining room was limited to be opened up to 4 inches with a window stopper. Carpet and soft cushioning were installed to the floor to prevent injury. Fire place was blocked by a shelve. A Gate was installed between living room and dining room. The front room was used for napping. Cribs and mats were used for napping. Boosters were used for feeding only. Children’s bathroom was clean and free of harmful objects. The lower bathroom cabinets and drawers were latched. There were no guns, no weapons and no pets in the house. Per licensee, children brought 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 10/4/2022. Licensee and her helper have completed the Child Abuse Mandated reporter training. They will expire in 3/5/2024. LPA reviewed the childrens' files and roster. LPA also obtained a copy of the roster from the licensee during the inspection. Per licensee, there was no children on special medication.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. 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: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1