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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002590
Report Date: 05/18/2023
Date Signed: 05/18/2023 05:01:32 PM


Document Has Been Signed on 05/18/2023 05:01 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:CHEN, RAYFACILITY NUMBER:
384002590
ADMINISTRATOR:CHEN, RAYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 218-0632
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94132
CAPACITY:14CENSUS: 8DATE:
05/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Ray Chen TIME COMPLETED:
05:00 PM
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On May 18, 2023., Program Analyst (LPA) Van performed an unannounced mandated annual inspection and met with helper DieZhu Chen. The Licensee, Ray Chen, arrived a moment later. LPA explained the objective of the inspection and was granted access to the property by the helper. Eight preschoolers are present today with two helpers and Licensee (4 infants and 4 preschoolers). The Licensee complies with the licensing capacity and limits today. All adults who live or work in the house have a criminal background check. The physical plant has not changed. The off-limits and childcare areas are the same. Childcare areas are on the lower level, including the garage converted into a childcare room (living room), family room, kitchen, and bathroom. Off-Limit Areas are the entire upper level and backyard. During the inspection, the Licensee requested to incorporate the backyard into the current license. LPA observed that only half of the backyard was renovated and set up to be used by children, and the other half still needed to be developed. The renovated backyard is located on the far end of the yard. The backyard is accessed from the backdoor through a narrow, fenced walkway path. The 1/2 backyard is completely fenced and clean with rubber tiles installed. There were multiple age-appropriate climbing structures and bicycles/tricycles available for children. LPA did not observe any potential hazard posed to the children. The ½ backyard is inspected and approved as of today, 5/18/2023. The days and hours of operation are Monday through Friday, 8:00 am to 6:00 pm.

LPA and the helper toured the childcare areas for health and safety hazards. The home childcare areas are clean and orderly. LPA observed age-appropriate toys and equipment present at home. The house has sufficient lighting and ventilation. A functional telephone, multiple working smokes and carbon monoxide detectors, and a fully charged 2A10BC fire extinguisher are all in the house.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023
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: CHEN, RAY
FACILITY NUMBER: 384002590
VISIT DATE: 05/18/2023
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LPA discussed the new Safe Sleep Regulation with the helper and informed the helper that there should be no toys or pillows inside the baby cribs/playpens and no objects hanging above them. LPA also discussed that all mattresses/padding should be designed for the particular cribs/playpens, and bedsheets should be tight-fitted. In addition, the helper was informed to physically check on the infant every 15 minutes during naptime and document them. The helper understood that no baby walkers, bouncers, exersaucers, or other similar items are permissible to be used during daycare hours. According to the Licensee, no bodies of water are on the premises. Daycare children have no access to detergents, disinfectants, or cleaning chemicals. The Licensee stated there are no guns or weapons in the house.

The Licensee maintains records for all children in her care, including vaccination records and Parental Rights forms. Each child had a complete emergency information card with the child's full name, phone number, and the location of a parent or authorized person who may be called in an emergency. The emergency drills are held at least once every six months, and each drill is appropriately logged/documented by the Licensee. The facility children's roster has been reviewed and found to be complete and current. License capacity and limitation options were reviewed, and the Licensee acknowledges that care cannot be provided over the capacity specified on the license. The requirements for reporting suspected child abuse, as well as reporting requirements for unusual incidents, were discussed. The Licensee and helpers kept up with their immunizations, Mandated Reporter Training AB 1207. The home has proper daycare liability insurance. Pediatric CPR/First Aid for Licensee and helpers are valid until 2025. The Licensee posted all required paperwork, including the facility License, Notification of Parental Rights, Earthquake Preparedness Checklist, and Notification of Personal Rights.
All mandatory postings (License/Parent's Rights poster/Emergency Disaster Plan and Earthquake Preparedness Checklist) are posted. According to the Licensee, fire and earthquake drills are conducted at least once every six months. The last drill occurred on 4/11/2023, and all drills were documented correctly.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
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: CHEN, RAY
FACILITY NUMBER: 384002590
VISIT DATE: 05/18/2023
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The 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.

LPA discussed the safe sleep regulations with the Licensees and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.

The 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.

Licensees were informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

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.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
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: CHEN, RAY
FACILITY NUMBER: 384002590
VISIT DATE: 05/18/2023
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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.

Licensee Ray Chen read and signed the report. During today's inspection, no deficiencies were discovered. Today's report and site visit notice was provided to the Licensee. LPA informed the Licensee that a 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: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
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