414001831-6-3-2019-05-CC-GSIH-BCSQPM-20190603122057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001831
Report Date: 06/03/2019
Date Signed: 06/03/2019 12:21:01 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:	LEONG, GRACE FANG		FACILITY NUMBER:	414001831
ADMINISTRATOR:	LEONG, GRACE FANG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 522-8353
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	14	CENSUS: 10	DATE:	06/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Grace F. Leong & Jung Leong		TIME COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Singh met with licensee, Grace Fang Leong, and her husband, Jung Leong, for an annual random inspection. The purpose of the inspection was explained. Licensee lives in a single family home. Present, there are ten preschool age children in care with licensee and her husband. All adults living or working in the home have criminal background check on file. Licensee is operating within the capacity of this date. Licensee provides day care from Monday to Friday between 7:30 AM to 6 PM. LPA inspected the day care areas with the licensee. Day Care Areas: Family room in the backyard, attached bathroom and Backyard. Off limit areas: Entire main house. There is no pool, spa or any other body of water in the house. As per licensee, there is no firearm or weapon in the house. All the cleaning supplies, poisons and other chemicals are stored in the house and are inaccessible to the children. There is no fireplace and stairs in the day care area. The day care room is free of hazards with proper temperature and ventilation. There is carbon monoxide detector, smoke detector, fully charged fire extinguisher and working telephone available in the house. There is a variety of age appropriate toys in the house. At 11 AM, LPA review the children's record. LPA reviewed the identification and emergency information form for every child for proper names and numbers filled. Licensee has record of each child’s immunization on file. LPA observed licensee has Acknowledgement of receiving licensing reports signed by parents in each child’s records. LPA observed parents has signed to acknowledgement of receiving discipline policy. Licensee has record of training of preventive health and CPR card valid until July, 2019. During inspection, Licensee showed the proof of signed for renewing the CPR, and the class will be on July 13, 2019. Per licensee, licensee conduct the fire and emergency drills in middle of every month. Per licensee’ s records, last drill was conducted on May 15, 2019. Immunization records of licensee and her husband was checked during previous inspection. See next page for continuation ................

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

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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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: LEONG, GRACE FANG	FACILITY NUMBER: 414001831
	VISIT DATE: 06/03/2019

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Continuation from previous page ..........

LPA review AB 1207 with the Licensee. As of January 1, 2018 all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encourage the licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

LIC809 (FAS) - (06/04)

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