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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004056
Report Date: 11/18/2020
Date Signed: 11/18/2020 03:49:26 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:HO, WING MEIFACILITY NUMBER:
384004056
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
11/18/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Wing Mei Ho aka Jenny HoTIME COMPLETED:
10:00 AM
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Licensing Program Analyst, LPA Yee conducted a teleconference inspection today. Licensee, Wing Mei Ho aka Jenny Ho, has requested to increase her capacity to a large license. Present at the daycare are 2 children, a licensee, and one helper. LPA conducted a visual inspection today. Current residents are Jenny Ho, her 14 years old daughter, two tenants, her brother (only on the weekend), and her parents (visiting only). All adults living at the facility are fingerprint cleared. The home is owned by Ms. Ho's brother. The lease agreement is on file. Day-care areas (upstairs level): living room, hallway bathroom, and backyard. The remaining areas of the home are off-limit. The home is equipped with a smoke alarm, carbon monoxide detector, and fire extinguisher. LPA advised Ms. Ho to conduct an emergency drill once every 6 months and keep a log sheet. The home has age-appropriate toys and equipment available for the children in care. The form of discipline was discussed. CPR & 1st aid certificate is current until 10/2022. Mandated Reporter Training, AB1207 certificate was completed on 9/19/2020. LPA reminded the licensee that all staff members must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. www.mandatedreporterca.com.
SIDS "A Child Care Provider's Guide to Safe Sleep" was discussed.

Technical Assistance for COVID-19 and posting requirement was discussed.

Fire clearance approval is needed for a large license.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020
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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