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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002447
Report Date: 04/19/2022
Date Signed: 04/19/2022 12:23:50 PM


Document Has Been Signed on 04/19/2022 12:23 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:HUNG, YUK YINGFACILITY NUMBER:
414002447
ADMINISTRATOR:HUNG, YUK YINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 401-5690
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY:14CENSUS: 7DATE:
04/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Yuk Ying HungTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection. LPA met with the licensee, Yuk Ying Hung, her husband, and her helper. All adults were fingerprinted. The purpose of the inspection was explained to her. There were 7 children that included 3 infants with 2 helpers present. The licensee own single family house with 7 bedrooms, 4 baths, living room, dining room, family room, and backyard house, The licensee lives in the house with her husband and adult child, The facility's operation hours are Monday to Friday from 8AM to 5:30PM. The daycare areas were living room, dining room, and bedroom #1, hallway bathroom that next to Bedroom #1, and backyard. The off-limit areas were the entire upper level, kitchen, Sunroom with a bathroom, and garage. Per licensee, she requested to add the sunroom to the daycare in last inspection dated on 5/23/2018. Per licensee, she submitted a copy of the new facility's sketch to the CCL in 2018. The fire marshal inspected the room afterward. However, CCL hasn't received any fire clearance for the room from the fire department. The licensee will submit a copy of the facility's sketch and application for adding room to CCL soon LPA inspected the facility for health and safety hazards The licensee installed a gate to the stariway to prevent children access to the off-limit area. All the electrical outlets were covered. A child proof knob was installed to the main door to prevent child leave the facility by themselves. There were a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detectors, and first aid supplies available. The daycare children brought their own food to the daycare. The kicthen door was latched The children's bathroom was clean and in order, The lower bathroom sink cabinet and drawers were either latched or free of harmful objects. High chairs were available for feeding only. The children cannot stay in the chair more than 15 minutes after meal. The fireplace was blocked by a shelf, The outdoor play yard was completely fenced. There was a big slide structure with grass underneath as the soft cushioning, The licensee had some chickens that were barricaded in the back of the yard. Play pen and cribs were used for napping. The licensee and helper had current CPR/First Aid training for review during the inspection. They will expire in 2/2023. Per licensee, there were no guns, and no weapons. in the house. The licensee had a cat that was kept in the off-limit area. All the required postings were posted. The facility had touchless Thermometer, hand sanitizer, and disinfectant to prevent COVID19.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2022
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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