384002633-11-21-2023-05-CC-CMOK-CXSS5A-20231121123400

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002633
Report Date: 11/21/2023
Date Signed: 11/21/2023 12:35:31 PM

Document Has Been Signed on 11/21/2023 12:35 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:	ZHENG, SHI YING		FACILITY NUMBER:	384002633
ADMINISTRATOR:	ZHENG, SHI YING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 601-7480
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94134
CAPACITY:	14	CENSUS: 5	DATE:	11/21/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Shi Ying Zheng (Michelle)		TIME COMPLETED:	01:00 PM

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	Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA Met with the licensee, Shi Ying Zheng(Michelle), and explained the purpose of the inspection. The licensee is a primary Chinese Speaker (Cantonese and Mandarin). There was no children upon LPA's arrival, and the children started coming in at different time during the inspection. 5 children including a toddler present with the licensee during the inspection. Licensee owns and lives with her husband and 5 minor children in this 2-story single-family house. The house has 3 bedrooms & a bathroom on the upper level; it has 2 bedrooms and 2 bathrooms on the lower level. The daycare areas are the entire downstairs including an in-law and a backyard. The off-limit areas are the entire upper level, on the lower level including a garage, kitchen area, and a bathroom (for the adult) by the main entrance. LPA toured and inspected the facility for health and safety hazards. The facility was clean and in order. All toxins and harmful objects were locked and made inaccessible to children. There were plenty of age-appropriate toys, books, learning material, and equipment, and children's furniture were in good condition and repaired in the daycare area. There were the fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detectors, working telephone, and first aid supplies available in daycare. All electrical outlets have built-in covers to prevent children from accessing them. The right amount of cubbies was available for the children to store their belongings. The licensee installed a gate at the entrance of the food preparation area to prevent children's access. The facility has a bathroom for children next to the diaper-changing table with a sink as well. The children's bathroom was clean and cleared of toxins and harmful objects. Cots and cribs were available for napping. Childproof knobs were installed on the doors of the adult bathroom in the front and storage room to prevent children's access to the off-limit areas. The licensee provides breakfast, AM/PM snacks, lunch, and dinner to the daycare children or children can bring their food to the daycare. All sharp corners were covered. All lower cabinets were latched. The Outdoor play area was completely fenced. Part of the outdoor play area with shade, so the children can have outdoor activities during rainy days. The licensee installed the soft cushioning to the entire outdoor play area to prevent injury. There were plenty of age-appropriate outdoor toys, a play house, a play structure with slides, and ride-on toys available for children. Per the licensee, there were no guns, weapons, or pets in the house. The licensee and her husband had current CPR/First Aid & Child Abuse Mandated Reporter Training that will expire in 1/2025 & 10/2024, & 2/18/2023 & 6/3/2023. The facility conducts the disaster drill at least 2 times a year. The latest drill was conducted on 7/2023. Per the licensee, there were no children on special medication. LPA reviewed the children's file and obtained a copy of the current children's roster from the licensee during the inspection. LPA also reviewed the 15-minute nap log during the inspection. Continues on LIC 809D

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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: ZHENG, SHI YING	FACILITY NUMBER: 384002633
	VISIT DATE: 11/21/2023

NARRATIVE

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Criminal Record Clearance - Licensee was reminded that all adults 18 and over living or working in home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Safe Sleep - LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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: ZHENG, SHI YING	FACILITY NUMBER: 384002633
	VISIT DATE: 11/21/2023

NARRATIVE

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MyChildCarePlan.org – Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law - During the exit interview, the LICENSEE ****, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the licensee, Shi Ying Zheng (Michelle).
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

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