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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002833
Report Date: 01/28/2020
Date Signed: 01/28/2020 03:35:53 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:NGTSANG, SHIU KUEN & TSANG, CHO YFACILITY NUMBER:
384002833
ADMINISTRATOR:NGTSANG, SHIU KUENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 309-8532
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 10DATE:
01/28/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Shiu Kuen NgTsang aka "Barbara"TIME COMPLETED:
04:00 PM
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2, Licensing Program Analyst, LPA Yee conducted an annual random inspection today. There are 10 napping children, licensee, Shiu Kuen "Barbara", co-licensee Cho Y present today. Residents at the facility are Barbara and her husband, Cho only. No change in the daycare areas as previously licensed. Day-care areas (lower level): large living room, a bedroom located in the back, middle room and backyard. The entire upper level is off-limit. CPR and first aid certificates are current until 4/2020. The daycare areas are neat and clean. The home is equipped with a smoke detector, a carbon monoxide detector, and a fully charged fire extinguisher. Required staff immunization is on file. Child Abuse Mandated Reporter Training certificates, AB1207 are on file. LPA reminded licensee that the training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. www.mandatedreporterca.com. Fire drill and emergency were practiced in January-2020. A log sheet was reviewed during the inspection. The facility provides morning snacks, afternoon snacks, and lunches. The discipline policy is communication. The roster was reviewed. SIDS " A Child Care Provider's Guide to Safe sleep" was provided. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, an updated Plan of Operation that includes 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. The facility is currently not providing these services. However, the licensee said she will have a written plan to CCL when she provides the services.

website: www.ccld.ca.gov. Title 22, Div 12, Chp3
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
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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