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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002486
Report Date: 04/25/2023
Date Signed: 04/25/2023 05:43:27 PM


Document Has Been Signed on 04/25/2023 05:43 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:QIU, EILEENFACILITY NUMBER:
384002486
ADMINISTRATOR:QIU, EILEENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 307-7035
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY:14CENSUS: 6DATE:
04/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Eileen QiuTIME COMPLETED:
05:45 PM
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 On April 25, 2023, Licensing Program Analyst (LPA) Van performed an annual 1-year mandatory inspection, which included checking the interior and exterior of the facility and discussing the required childcare paperwork with the Licensee. LPA met with Licensee Eileen Qiu. The purpose of the inspection was explained, and the Licensee granted LPA entry to the home. Today's six children (2 infants and four preschoolers) with the Licensee and two helpers. The facility complies with the staff-children ratios today. All adults living or working in the home have a criminal background clearance. Childcare areas are on the ground level, including a nap room, a family room, and a bathroom. Off-limit areas are the entire second floor and the garage. All off-limit areas are adequately barricaded. The Days and operation hours are 8:00 am – 5:30 pm, Monday – Friday.
LPA reviewed and inspected the Licensee's interior and outdoor play facilities for health and safety. LPA observed the house to be in good condition, with appropriate temperature and ventilation. The facility offered a good selection of age-appropriate toys and equipment. All cleaning supplies, poisons, and other chemicals were kept out of reach of children behind child-proof locked cabinets. The house has a fully charged fire extinguisher, smoke and carbon monoxide detectors, and a functional phone. The facility has a fully stocked first aid kit available for children. No pools, spas, or bodies of water were on the site. The backyard is completely fenced. The backyard is well-stocked, with outdoor toys and equipment in good working order. All play structures are placed in the grassy to absorb children's accidental falls. Water bottles or pitchers are available for children indoors and outdoors.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: QIU, EILEEN
FACILITY NUMBER: 384002486
VISIT DATE: 04/25/2023
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 LPA reviewed the records of the children. The Licensee maintains thorough records for all children in their care, including vaccination records and Parental Rights forms. LPA noted that each kid had a complete emergency information card that included the child's full name, phone number, and the location of a parent or authorized person who may be called in an emergency. The Licensee and helpers' Pediatric First Aid/CPR certifications are valid until 2024. In addition, the Licensee and helpers maintained their immunizations and Mandated Reporter Training AB 1207. The facility has proper daycare liability insurance. The most recent fire & earthquake drill was held on March 1, 2023.
All mandatory postings are observed posted (License/Parent's Rights poster/Emergency Disaster Plan and Earthquake Preparedness Checklist).
During the inspection, the following was discussed and provided to the Licensee
· The Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.
· LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.
· LPA discussed care and supervision with the Licensee. Capacity options were reviewed, and the Licensee acknowledges that care cannot be provided over the capacity specified on the license.
· For additional questions, the Licensee was advised to contact the CCLD office, Monday to Friday, 8:00 am - 5:00 pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: QIU, EILEEN
FACILITY NUMBER: 384002486
VISIT DATE: 04/25/2023
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 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: www.ada.gov/childqanda.htm.
LPA discussed the safe sleep regulations with 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. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies were cited today under CCR, Title 22, Div. 12.

Licensee Eileen Qiu read and signed the report. Today's report and site visit notice was provided to the Licensee. LPA informed the Licensee that the site visit notification must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
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