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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004015
Report Date: 08/16/2022
Date Signed: 08/16/2022 03:32:36 PM


Document Has Been Signed on 08/16/2022 03:32 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:LI, LI PINGFACILITY NUMBER:
384004015
ADMINISTRATOR:LI, LI PINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 606-6014
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 8DATE:
08/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Li Ping LiTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Yee conducted a Required - 1 Year inspection today. The purpose of the inspection was explained. LPA toured the facility with the licensee's daughter-in-law. Present at the facility are Li Ping, daughter-in-law, one helper and 8 children. Current residents at the facility are Li Ping, her son, her daughter-in-law, two grandsons (8 yr old, 4 yr old). The personnel summary report was reviewed with Li Ping and she said it's current. Days and hours of operation: Monday - Friday, 8:00 am- 5:30 pm.

Daycare areas (lower level): one large room, bathroom, and backyard. The remaining areas of the house are off limits.

The home is clean orderly and ventilated properly. The home is equipped with a 2A10BC Fire extinguisher, smoke detectors and carbon monoxide. Cleaning compounds, detergents, medications are made inacessible to children in care. Kitchen/Bathroom cabinets/drawers are made inacessible to children in care. Li Ping and helper have current First aid and CPR which expires 02/2024, 04/2024 . The last fire drills/earthquake drills was conducted on 08/08/2022. A log sheet was available during the visit. Roster was available. Disciplinary policy was discussed with Licensee today. The facility participate in food program. Home has age appropriate toys and equipment available for the children in care.

LPA reviewed 8 children's files and found two children do not have immunization on file. The licensee said the two children are new and she will remind the parents to submit the records during pick up.

"Infant Sleeping Plan". Safe sleep regulations was explained. LPA provided a blank sheet of LIC9227 and a sample sheet of a log sheet today for future use. The facility has no infants at this time.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/16/2022
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LI, LI PING
FACILITY NUMBER: 384004015
VISIT DATE: 08/16/2022
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LPA also review Licensee and assistant files. The licensee and both helpers have Child Abuse Mandated Reporter Training completed on 2/26/2021, 8/21/2021, 6/12/2022.

LPA discussed Child Abuse Mandated Reporter Training AB1207 with Licensee. As of January 1, 2018 all staff will be required to complete Child Abuse Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Licensee was also informed that 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 or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. One helper is missing pertussis and measles. The helper said she will obtain the record from her doctor. The licensee will submit to CCL via email.

The licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

An exit interview was conducted. A copy of this report was provided. Notice of Site Visit is to remain posted for 30 days. For updates 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: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3