384002486-3-13-2020-05-CC-BVAN-BMNNGB-20200313102652

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002486
Report Date: 03/13/2020
Date Signed: 03/13/2020 10:27:33 AM

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:	QIU, EILEEN		FACILITY NUMBER:	384002486
ADMINISTRATOR:	QIU, EILEEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 307-7035
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	14	CENSUS: 3	DATE:	03/13/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Eileen Qiu		TIME COMPLETED:	10:45 AM

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	On March 13, 2020, at 8:40 am, Licensing Program Analyst (LPA) Van met with the licensee, Eileen Qiu, for an unannounced annual inspection. The purpose of the inspection was explained and was granted entry to the home by the licensee. Present today are three children with the licensee and two helpers. The facility is in compliance with the staff-children ratios today. All adults living or working in the home have criminal record clearances on file with the Department. At 9:05 am, LPA, along with the licensee, inspected the daycare areas for health and safety hazards. The home is a two-level single-family house. The licensee owns the house. Daycare areas are on the ground level, including a nap room, a family room, and the bathroom. During today's inspection, the licensee decides to make the kitchen and the bedroom on the second floor an off-limit area. Off limit areas are the entire second, the garage, the kitchen, and the bedroom. The home is adequately ventilated. There are no pools, spas, or other bodies of water on the property. Per the licensee, there are no guns, weapons, or pets in the home. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. There is a child gate at the base of the staircase. The home is equipped with a fully charged fire extinguisher, smoke and carbon monoxide detectors, and a working telephone. There is an adequate supply of toys and other learning equipment for the children. Furniture, including pack-n-play, high chairs, and chairs are in good condition. Cots are provided to older children for napping. LPA did not observe any walkers, bouncers, or any similar items. Licensee understands that smoking is prohibited in family child care homes. Per licensee, sick children will be separated from the group and will be waited in one of the nap rooms for the parent to pick up.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: QIU, EILEEN	FACILITY NUMBER: 384002486
	VISIT DATE: 03/13/2020

NARRATIVE

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LPA reviewed supervision and capacity requirements/expectations. The licensee states that she does not transport children but understands never to leave children unattended in vehicles. The licensee states she understands her capacity options.

At 9:45, LPA reviews records of children and staff. The licensee has a complete and current roster of children in care. Per licensee, fire drills are conducted every six months, and a record of the drill was documented accordingly, and the last fire drill was performed on 11/27/2019. The licensee has complete records for children in care, including immunization records and Parents' Rights forms. Licensee and helpers have valid Pediatric FirstAid and CPR in the file.

Licensee is aware that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety Code 1597.662.

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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA also discussed the Family Child Care Home checklist with the licensee and provided the checklist to the licensee as a reference for future inspection guide.

No deficiencies were observed in today's inspection. A copy of this report was reviewed and provided to the licensee. This report will be kept in the facility file and will be made available for public review upon request. Notice of Site Visit was observed to be posted and shall remain posted for 30 days

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020

LIC809 (FAS) - (06/04)

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