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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002281
Report Date: 05/17/2022
Date Signed: 05/17/2022 11:00:50 AM


Document Has Been Signed on 05/17/2022 11:00 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:PUREVDORJ, TUULFACILITY NUMBER:
384002281
ADMINISTRATOR:PUREVDORJ, TUULFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 623-0954
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:14CENSUS: 7DATE:
05/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Tuul PurevdorjTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection. LPA met with the licensee, Tuul Purevdorj, and her helper. All adults had fingerprint clearance. The purpose of the inspection was explained to them. There were 7 children that included 2 infants with a helper present. The facility's operation hours were Monday to Friday from 8AM to 5:30PM. LPA inspected the facility for health and safety hazards. Licensee has rented the unit on the ground. Licensee was the only person lives at this home. The unit had one bedroom, 1 1/2 bath, a play room, dining/Kitchen area and the backyard in this facility. The whole unit was used for day care. The facility was clean and in order. Temperature and lighting were adequate. The licensee installed the soft cushioning to the entire floor to prevent injury, The licensee also installed the gates at the main and hallway entrances to prevent children access to the off limit areas. There were plenty of age appropriate toys, books, learning material and children's furniture that were in good condition and repaired. there were a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detector, and first aid supplies available. There were no pets in the facility. High chairs and boosters were used for feeding only. The children have to be removed from the chair when they finish the meals. Right amount of cubbies were available for children to store their belongings. Play pens and mats were used for napping. Per licensee, she has provided meals to the daycare children who are over 1 year old. The children under one year old have brought their own food to the daycare and kept in the kitchen area. The children's bathroom was clean and free of harmful object. The lower kitchen cabinet and drawers were free of harmful objects. The licensee installed a child proof knobs to the stove. The outdoor play area was fenced completely. A gate was installed to the stairway to prevent children access to the off-limit area. The facility has conducted a disaster drill at least 2 times a year and logged. The licensee and helper had current First Aid and CPR training certificate for review during the inspection. The certificate will expire in 12/2022 and 7/2023. The licensee had current Child Abuse Mandated Reporter training. There were no children on special medication. LPA reviewed the staff and children files during the inspection. LPA also obtained a copy of the current Children's roster from the licensee during the inspection. All the required postings were posted. The licensee had a touchless thermometer and hand sanitizer to prevent COVID19 by the main doorway.

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: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2022
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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