384004182-10-28-2019-05-CC-CMOK-BHDVSJ-20191028164138

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004182
Report Date: 10/28/2019
Date Signed: 10/28/2019 04:41:41 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:	NG,CINDY YUE ZHEN		FACILITY NUMBER:	384004182
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	10/28/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Cindy Zhen		TIME COMPLETED:	05:05 PM

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Licensing Program Analyst (LPA) Mok conducted an unannounced case management inspection. LPA met with the licensee, Cindy Zhen. The purpose of the inspection was explained to them. There were 5 children included 1 infant present. Licensee applied for capacity change on 10/1/2019. LPA toured and inspected the facility for health and safety. The daycare areas are the entire lower level except garage and backyard. The Off-Limit areas are the entire upper level, garage and backyard. The daycare facility was clean and in order. The lighting and temperature were adequate. There were plenty of age appropriate toys, books, learning material and children furniture available. The lower cabinets and drawers at the food preparation area were free of dangerous items. There were a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detector, and first aid supplies available. The children’s bathroom was clean and free of hazard. The lower bathroom cabinet and drawers were free of dangerous items. The mechanical door chimes were installed to the main entrance door and the side gates to prevent children access to the off-limit area. Cribs and cots were used for napping. All electrical outlets were covered. Child proof knobs were installed to the doors of the garage and bedroom to prevent children access to the off-limit area. Per licensee, she wants to include the backyard to the daycare area. LPA inspected the backyard for health and safety hazard. The backyard was not completed, so LPA couldn’t approve during the inspection. As of today, Licensee is approved for Large Family Child Care License.

The following item must be completed. Licensee also need to submit the Pictures of the correction to the CCL for the approval before it’s included to the daycare areas.

· Border Fence Panels have to be installed to the garden beds in the backyard.

This report was reviewed and explained to the licensee. The notice of Site visit was given as well.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019

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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