414001831-12-20-2023-05-CC-JTSE-CYPVM8-20231220153307

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001831
Report Date: 12/20/2023
Date Signed: 12/20/2023 03:33:17 PM

Document Has Been Signed on 12/20/2023 03:33 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
SAN BRUNO CC RO, 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: 6	DATE:	12/20/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Licensee, Grace Leong		TIME COMPLETED:	03:45 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 12/20/2023, at approximately 1:45PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA was granted entry to the facility by Licensee, Grace Leong. LPA explained the purpose of the visit. Present during the visit were Licensee, Helper (H1), and six preschool age children. The facility is in compliance with capacity requirements on this day. All adults working or living in the home have acquired fingerprint clearance and are associated to the facility. The facility operates as a Chinese-immersion program, 7:30AM to 6:00PM, Monday to Friday. Daycare Areas: Detached Living Room (Main Classroom), Bathroom in Detached Living Room, and Backyard. Off-limits Areas: Entire main home. LPA inspected the daycare areas for any potential health and safety hazards. LPA observed the Main Classroom to be in clean and orderly condition. There are age-appropriate toys and learning materials in the Main Classroom. There is a fully charged 3A40BC fire extinguisher present. There are two combination smoke and carbon monoxide detectors in the Main Classroom, in addition to a fire alarm system. Cabinets are secured by childproof locks. Poisons, cleaning detergents and other chemicals are stored inaccessible to children. LPA observed the first aid kit to be fully equipped. Electrical outlets were observed to be covered or rendered inaccessible to children by furniture. The facility provides bedding for children and washes the bedding once a week. Per Licensee, there are no weapons or firearms in the home. The Backyard is completely padded with foam mats and artificial turf that provide sufficient cushioning for children to play on. There is a play structure that is available for older children to play on. Younger children do not have access to the play structure. LPA observed there to be age-appropriate toys and play equipment for children. There are no pools or other bodies of water present in the facility. Continued on Page Two

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LEONG, GRACE FANG	FACILITY NUMBER: 414001831
	VISIT DATE: 12/20/2023

NARRATIVE

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LPA reviewed six children’s files. All children’s files were observed to be complete, and included Identification and Emergency Information (LIC700), Consent for Emergency Medical Treatment (LIC627) and Notification of Parents’ Rights (LIC995A). LPA observed Licensee’s and H1’s First Aid/CPR and Mandated Reporter Training to be posted with required postings. Licensee’s First Aid/CPR expires 8/2025, and Mandated Reporter Training expires 9/2024.

LPA observed all required postings to be posted in the entryway of the Main Classroom. The facility has also posted a daily activity schedule and a menu for parents to review. There is a sign-in sheet present in the entryway of the Main Classroom. LPA advised that all emergency drills should be properly documented and logged. Licensee agreed. The facility provides lunch and AM/PM snacks for children in care.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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-andresources/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.
Continued on Page Three

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LEONG, GRACE FANG	FACILITY NUMBER: 414001831
	VISIT DATE: 12/20/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited during today's visit.

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

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

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

LIC809 (FAS) - (06/04)

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