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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002482
Report Date: 04/06/2022
Date Signed: 04/06/2022 11:38:21 AM


Document Has Been Signed on 04/06/2022 11:38 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:JIANG, WAN RUFACILITY NUMBER:
384002482
ADMINISTRATOR:JIANG, WAN RUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 672-7362
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 9DATE:
04/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Wan Ru JiangTIME COMPLETED:
11:50 AM
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Licensing Program Analyst, LPA Yee conducted a Required - 1-year inspection today. The purpose of the inspection was explained. The daycare located on the ground level. The entrance to the daycare is on the right side of the house. Present at the daycare are 9 children(3 infants), Wan Ru Jiang, and her husband. LPA toured the daycare with Wan Ru. Current residents are Wan Ru, her husband, and their adult son and 10 years old daughter. The facility personnel summary report was reviewed with Wan Ru and she said it's current. Day Care Areas (lower level): living room, study room, bathroom, bedroom #1 and backyard. LPA mentioned about the "Minor Renovation and Repairs Grant". She said she is aware of it and has already applied for the grant.
The remaining areas of the house are off-limits ( the entire upper level, garage). The home is equipped with a smoke detector, a carbon monoxide detector, and a fully charged fire extinguisher. The licensee and helper, CPR & 1st aid are current until 10/4/2022, 3/2024. The facility is on the food program. Child Abuse Mandated Reporter Training, AB1207 certificate is current, completed on 01/01/21. Bother licensee and helper completed on the same day. LPA reminded the licensee that the training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. www.mandatedreporterca.com. Liability insurance is on file.
LPA discussed the safe sleep regulations with the licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. The roster was reviewed. "Individual Infant Sleep Plan", LIC9227 was on file for infants who are less than 12 months old. Infants were checked every 15 minutes and a log sheet was reviewed. The facility is in compliance.

Website: www.ccld.ca.gov. Title 22, Div 12, Chp 3
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/06/2022
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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