<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002641
Report Date: 11/25/2019
Date Signed: 11/25/2019 01:53:24 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:LI, CUILINGFACILITY NUMBER:
384002641
ADMINISTRATOR:LI, CUILINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 387-2802
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:14CENSUS: 10DATE:
11/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Cuiling Li (Linda)TIME COMPLETED:
02:15 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 increased inspection today. LPA met with the licensee, Cuiling Li (Linda), and a helper who has fingerprint clearance. The purpose of the inspection was explained to them. There were 10 children included 3 infants present with a helper. Licensee is a primary Chinese Speaker. Licensee and a helper had current CPR/First Aid training, they will expire in 5/2021 and 12/2020. Licensee owns this 2 story single family house. Licensee lives in the house with her husband, and her daughter. The daycare areas are the entire lower level including kitchen/dining area, 2 rooms (play room and nap room), and backyard. Per licensee, the backyard was temporarily closed due to cleaning. It will be reopen by tomorrow. The off-limit areas are the entire upper level and a garage. LPA toured and 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 either locked or made inaccessible to the children. Soft cushioning was installed to the entire daycare area to prevent injury. Gates were installed at the daycare and nap room entrances. All lower kitchen cabinets and drawers were either latched or free of harmful items in its. There were plenty of age-appropriate toys, books, learning material, and children’s furniture available for children. There were a fully charged 2A10BC fire extinguisher, working smoke detector, and fire aid supplies available. Licensee also had the carbon monoxide detector available in the daycare areas. All electrical outlets were covered. Children’s bathroom was clean and free of harmful objects. Cubbies were available for children to store their own belongings by the daycare entrance. Cots and crib were used for napping. High chairs were available for feeding only. Outdoor play area was completely fenced. Soft cushioning was installed to the entire ground to prevent injury. Some outdoor toys were available for children such as play house, and ride-on-toys. Per licensee, there were no guns, no weapons, and no pets in the house. Fire drill has been conducted 2 times a years. The latest drill was conducted in 7/2019. Facility provides breakfast, AM/PM snacks, lunch, and dinner to the children. Per licensee, there were no children on special medication. 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 facilities and the ADA, available at: http://www.ada.gov/childqanda.htm. Licensee and her husband completed the Child Abuse Mandated Reporter Training. Her helper will complete the Child Abuse Mandated Reporter Training in Chinese at Dept. of Public Health. All required postings were posted. Children files and roster were reviewed during the inspection. LPA also obtained a copy of the current roster from licensee during the inspection.

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 inspection. Notice of site visit was provided. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1