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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002482
Report Date: 05/01/2023
Date Signed: 05/01/2023 04:27:48 PM


Document Has Been Signed on 05/01/2023 04:27 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
SAN BRUNO CHILD CARE, 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: 6DATE:
05/01/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Wan Ru JiangTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Yee conducted a case management visit today. The licensee requested to add her kitchen to do a cooking project with the children. LPA inspected the kitchen and the kitchen needs to be clean and orderly. The off-limit areas need to be gated to prevent access. LPA will conduct another visit when the licensee is ready.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/01/2023
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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