414001831-8-22-2022-05-CC-CQUO-CHJQ9F-20220822115816

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001831
Report Date: 08/22/2022
Date Signed: 08/22/2022 11:58:21 AM

Document Has Been Signed on 08/22/2022 11:58 AM - 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:	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: 5	DATE:	08/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Grace Fang 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	On August 22, 2022 at approximately 10:40am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Grace Fang Leong, and explained the purpose of the inspection. At the started of LPA's visit, licensee, licensee's spouse and 4 enrolled children (all preschool age), were present in the day care areas. Hours of operations are Monday to Friday from 7:30am to 6:00pm. At approximately 10:50am, additional enrolled child arrived to facility. Present during inspection included 5 enrolled children (all preschool age). Licensee is operating within capacity limits and ratio during LPA's visit. Licensee lives in the home with spouse and adult child. All adults living in the home have fingerprint clearance on file. The home includes main home, detached living room converted into a classroom with a restroom, and backyard. The DAY CARE AREAS are detached living room (main classroom), restroom in detached living room, and backyard. The OFF LIMIT AREAS are entire main home. Main home is made inaccessible with locked doors and/or gates. All individuals entering the main classroom enter through the side gate, located on side of the house with separate doorbell. At approximately 11:00am, LPA inspected day care areas for health and safety hazards. LPA observed home to be clean, in good repair with proper temperature and ventilation. All cleaning supplies, poisons, and other chemicals were inaccessible to children, in high shelves and/or locked behind child safety cabinets. Main classroom is equipped with a smoke and carbon monoxide detector, fully charged fire extinguisher and fire alarm system. Per licensee, there are no weapons or firearms in the home. (Continue on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

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: 08/22/2022

NARRATIVE

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Entire backyard is enclosed with an at least 5ft high fence. LPA did not observe home to have any pools, spas or bodies of water on the property. The backyard is equipped with appropriate outdoor toys and equipment that were in good working condition. LPA observed poles and sharp edges in backyard are adequately barricaded with appropriate cushioning installed. Climbing structures in backyard are in proper working condition with resilient padding underneath.

LPA reviewed five children's records which were complete. Children's records have a record of emergency identification on file. Licensee's CPR is current and will expire 08/2023. Emergency drills are conducted at least once every six months and are properly logged and documented. Last emergency disaster drill was conducted 08/17/2022.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over living or working in the home, 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.
(Continue Report on Page 3...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

LIC809 (FAS) - (06/04)

Page: 2 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: LEONG, GRACE FANG	FACILITY NUMBER: 414001831
	VISIT DATE: 08/22/2022

NARRATIVE

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://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.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Grace Fang Leong.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

LIC809 (FAS) - (06/04)

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