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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002969
Report Date: 10/09/2019
Date Signed: 10/09/2019 04:40:18 PM

COMPREHENSIVE INSPECTION
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:LIANG, SHUMINFACILITY NUMBER:
384002969
ADMINISTRATOR:LIANG, SHUMINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 696-4298
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:14CENSUS: 8DATE:
10/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Liang, Shumin and Guan SuqinTIME COMPLETED:
04:40 PM
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Licensing Program Analyst (LPA) Van met with Licensee, Shumin Liang and licensee's helper S1 for an unannounced annual random inspection. The purpose of the inspection was explained and was granted entry to the home by licensee. Present today is 8 children (4 infants and 4 preschoolers) in care with licensee. Licensee is operating within teacher/child ratios. Days and hours of operation are Monday- Friday 7:30AM - 6:00PM. Day Care Areas are on the second floor level which includes the living room, dining room, bedroom, and backyard. Off-limits Areas are master bedrooms, garage, kitchen and the ground level. LPA and Licensee inspected the day care areas for health and safety hazards. The home is clean and well repair, it has properly lighting and ventilation. There are no pools, spas or other bodies of water on the property. Per licensee there are no firearms, weapons or pets in the home. Stair leading to the day care is barricaded. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. The home is equipped with a fully charged fire extinguisher, facility has multiple smoke & carbon monoxide detectors combo and a working telephone. There is an adequate supply of toys and other learning equipment for the children. Furniture, and high chairs are in good condition. LPA did not observe any walkers, bouncers or any similar items. Licensee understands that smoking is prohibited in family child care homes.
The licensee has a complete and up to date current roster of children in care. Fire drills are conducted and documented accordingly, last fire was completed on 9/30/19. The licensee has complete records for children in care, including immunization records, Parents' Rights forms, and Consent for Medical Treatment. Licensee has valid child care liability insurance in file and Pediatric FirstAid & CPR will expire on 8/25/21. LPA reviewed supervision, capacity requirements and expectations with licensee. Licensee stated that she does not transport children but understands never to leave children unattended in vehicles. Licensee stated she understands her capacity options. LPA reviewed safe sleep for infants and provided informational handout. LPA reminded licensee as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles. No deficiencies were observed today. A copy of this report was reviewed and provided to the licensee. This report will be kept in the facility file and will be made available for public review upon request. Notice of Site Visit was observed to be posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
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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