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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002624
Report Date: 03/12/2020
Date Signed: 03/12/2020 02:17:23 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:LIAO, YA LINGFACILITY NUMBER:
384002624
ADMINISTRATOR:LIAO, YA LINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 271-5955
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 9DATE:
03/12/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Ya Ling LiaoTIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst, LPA Yee conducted a required 1-year inspection today. The purpose of the inspection was explained. There are 9 children, licensee, Ya Ling Liao, and her husband present today. Current residents are Ya Ling Liao, her husband, and their son. All adults living or working in the home have a criminal background check on file. Days and hours of operation: Monday to Friday between 7:30 AM to 6:00 PM.

LPA inspected the day-care areas with Ya Ling Liao. Day Care Areas (street level): Living room #1, living room #2, bathroom and backyard. The remaining areas of the house are off-limits. Off limit areas are made inaccessible. The home is free of hazards with proper temperature and ventilation. Per Ya Ling Liao, a carbon monoxide detector, the smoke detector is working. A fire extinguisher is fully charged. The fire drill, earthquake drill were conducted once a month.

At 1:30 PM, LPA reviews the children's records. Some children's files are incomplete. LPA advised licensee to keep current records. She said she understands. The licensee has a record of children’s immunization. The licensee has a record of training of preventive health and CPR card valid until 4/6/2021.

Incidental Medical Services (IMS) policy was discussed. A written IMS plan is on file.
LPA review AB 1207 with the Licensee. As of January 1, 2018, all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Licensee completed AB 1207 on 5/13/2018. A certificate is on file.

LPA discussed the safe sleep regulation concepts and the handout was provided.
This report was reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for the next 30 days.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020
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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