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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002533
Report Date: 09/11/2019
Date Signed: 09/11/2019 04:32:20 PM

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:ZHOU, YAN HONGFACILITY NUMBER:
384002533
ADMINISTRATOR:ZHOU, YAN HONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 585-5290
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:14CENSUS: 6DATE:
09/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Yan Hong ZhouTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced increased inspection today.
LPA met with the licensee, Yan Hong Zhou, and her helper who has fingerprint clearance. Licensee is a primary Chinese Speaker. The purpose of the inspection was explained to her. There were 6 children included 2 infants present with a helper. The operation hours of the facility are Monday to Friday from 8 am to 6 pm. Licensee owns this 2 stories single-family house. Licensee lives in the house with her son who has fingerprint clearance. The house has 2 levels. The lower level has an in-law with one bathroom, one-bedroom, and a living room.
It has been occupied by the licensee. The upper level has 1 bedroom (since Licensee tore down bedroom #2 and #3 and converted them into one open area for large daycare on the upper level), 1 bathroom, living room with adjacent open kitchen. There was a door in the back of the open area for safety purpose. LPA inspected the facility for health and safety hazard. The house was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were made inaccessible to children. Per licensee’s request, she wanted to include her bedroom to the daycare area. LPA inspected the room for health and safety hazard. The room will be used for napping only. The Daycare areas are entire upper level, except kitchen area, licensee’s bedroom and front yard (It’s located next to the driveway). The Off-limit areas are entire lower level, driveway, backyard, and kitchen on the upper level. Soft cushioning was installed to the entire daycare area to prevent injury. There were plenty of age appropriate toys, books, children’s furniture, and learning material available for children. There was the fully charged 2A10BC fire extinguisher, a working telephone, and first aid supplies available at daycare. Smoke detector and carbon monoxide detector were not tested due to children were napping during the inspection. All electrical outlets were covered. High chair and boosters were available for feeding only. Mats and play pens were available for napping. The right amount of cubbies with children pictures were available to the children to store their belonging by the entrance. Childproof knobs were installed to the bedroom doorknob to prevent children access to the off-limit area. Chimes have been installed to main and back exits to prevent children leave the facility. Gate was used at the kitchen entrance to prevent children access to the off-limit area. Per licensee, there were no guns, no weapons, and no pets at home. Licensee and helper have current CPR/ First aid training that will expire in 8/2021 & 6/2021 Per licensee, the disaster drill is conducted 2 times a year. The latest drill was conducted in 5/2019. Licensee provides breakfast, snacks, lunch, and dinner to daycare children. Children’s bathroom was clean and in order. Lower bathroom cabinet was latched. The outdoor play area was completely fenced. It is located in the front of the house and next to the driveway. There was shade and soft cushioning installed in the play area. There were some age-appropriate outdoor toys, slide with soft cushioning underneath and some ride-on toys available for children. Children files and roster were reviewed during the inspection. LPA also discussed with licensee about IMS. Per licensee, there was no child on special medication. LPA also provided a sample of IMS in Chinese to licensee during the inspection. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm. Licensee and her helpers already obtained a certificate of Mandated reporter training. Licensee and helper have met the staff immunization requirement. The documents were reviewed during the inspection. Children files and roster were reviewed during the inspection. All required postings were posted.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. A Child Care Provider's Guide to Safe Sleep was provided to licensee during the inspection. Notice of site visit was provided. For a quarterly update on Licensing information, go to the CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
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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