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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002447
Report Date: 06/07/2022
Date Signed: 06/07/2022 10:44:03 AM


Document Has Been Signed on 06/07/2022 10:44 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:HUNG, YUK YINGFACILITY NUMBER:
414002447
ADMINISTRATOR:HUNG, YUK YINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 401-5690
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY:14CENSUS: 8DATE:
06/07/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Yuk Ying HungTIME COMPLETED:
11:00 PM
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Licensing Program Analyst (LPA) Mok , conducted an case management to add an additional room to the daycare area. LPA The purpose of the inspection was explained to her. There were 8 children that included 3 infants and 5 preschoolers with a helper who had fingerprint clearance. Per licensee request, she wanted to use a new family room in the back of the house and play yard for her daycare. LPA inspected the room for health and safety hazards. The family was located in the back of the house. The room had 2 bathrooms, 2 bedrooms, and one big activity area. It was separated the living room by a sliding door. There were plenty of age-appropriate toys, books. learning material, and children's furniture that were in good condition and repaired. The lower cabinet at the food preparation area was latched. The children's bathrooms were clean and in order. LPA didn't see any harmful objects in the bathrooms. The lower sink cabinets were free of harmful objects. Play pens, cribs, and cots were available for napping. High chairs were available for feeding only. The licensee installed some soft cushioning to the floor to prevent injury. The outdoor play yard was completely fenced. There were a plenty of age-appropriate outdoor toys, ride-on toys, and play structures available for the children. The licensee installed the soft cushioning underneath the play structure to prevent injury. The licensee had some chickens that were fenced in the backyard as well. The children cannot access to them. All the electrical outlets had child proof inner blockage. The daycare area will be in the family room and outdoor play area only. The living room will be used as pathway for the daycare only. The fire clearance was received by CCL on May 23, 2022.



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: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2022
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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