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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001816
Report Date: 02/14/2023
Date Signed: 02/14/2023 03:48:37 PM


Document Has Been Signed on 02/14/2023 03:48 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:LU, RITA RUEY-TINGFACILITY NUMBER:
414001816
ADMINISTRATOR:LU, RITA R.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 577-1715
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:14CENSUS: 10DATE:
02/14/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Rita Ruey-Ting LuTIME COMPLETED:
04:00 PM
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On 2/14/2023 at 3:00PM., Licensing Program Analyst (LPA) Luis J. Gomez met with Licensee, Rita Ruey-Ting Lu. Purpose of the inspection was explained and was for an unannounced; Plan of Correction inspection. Present was the licensee and two staff caring for 10 children. (9 preschool age, 1 infant age). All adults have criminal record clearances on file. LPA inspected facility for health and safety hazards.

During today’s inspection, LPA performed record review, site observations, and interviews.

At 3:05PM., LPA reviewed children files. LPA confirmed children’s file have been updated with missing immunization records. LPA reminded licensee to ensure immunization records are collected from authorized representatives prior to enrollment.

At 3:15PM., LPA inspected outdoor play area. Playthings were free of hazards or dangerous conditions. Licensee has removed exposed wiring from damaged play car.

Deficiency issued on 2/2/2023, has been cleared and ‘Cleared Plan of Correction Letter’ was provided.

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview and report discussed with Licensee, Rita Ruey-Ting Lu and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Licensee was advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2023
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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