414004119-8-11-2022-05-CC-HLEG-CH7VHY-20220811162756

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004119
Report Date: 08/11/2022
Date Signed: 08/11/2022 04:28:03 PM

Document Has Been Signed on 08/11/2022 04:28 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:	SHEN, YUNHAN		FACILITY NUMBER:	414004119
ADMINISTRATOR:	SHEN, YUNHAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(628) 800-2006
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY:	14	CENSUS: 10	DATE:	08/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Yunhan Shen		TIME COMPLETED:	04:25 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 8/11/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Yunhan Shen facility. LPA was granted entry by the Licensee, Yunhan Shen. LPA explained the purpose of the visit to the Licensee. All the facility's staff members have had their criminal background checks cleared by Guardian. LPA observed the Licensee and her helper supervising nine preschool children and one infant. From Monday to Friday, the hours of operation are 8:00 am. to 6:00 pm. Daycare Area(s): Living Room, Kitchen, Bedroom #2 for napping, and Bathroom #1. Off Limit Area(s): Bedroom #1, Bedroom#3, Deck, Lower Level, Garage, Family Room, Bedroom #4, Backyard, and Front yard. All off-limit areas are secured with a locked door or a safety gate. The Licensee understands that off-limits areas may not be used for childcare during business hours. Both LPA and the Licensee thoroughly checked the daycare areas for potential health and safety hazards. The daycare is outfitted with age-appropriate toys and equipment. The facility is well-lit, well ventilated, and free of defects or conditions that endanger children in care. The daycare is outfitted with a smoke detector, a carbon monoxide detector, and a fully charged fire extinguisher. All the electrical outlets and trash cans are covered. Children have access to first-aid supplies. Cleaning products, detergents, and other items that could endanger children are kept out of reach of children. LPA observed no walkers, bouncers, or other similar items. According to the Licensee, there are no firearms or weapons on the premises. LPA observed that there were no pools, spas, or other bodies of water in the facility. LPA observed that the Licensee had posted all the required forms, including the facility License, Notification of Parental Rights, Earthquake Preparedness Checklist, and Notification of Personal Rights. The licensee is aware that smoking is not permitted in family childcare facility. *See Page 2 for continuation*

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

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: SHEN, YUNHAN	FACILITY NUMBER: 414004119
	VISIT DATE: 08/11/2022

NARRATIVE

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LPA reviewed the records of the ten children. All required forms were in the children’s file. All the children have an emergency information card in their file, which includes their full name, phone number, and the location of a parent or other responsible adult who can be contacted in an emergency. The children's file included parental consent for the Licensee or registrant to consent to emergency medical care, as well as the child's physician's name and phone number.

LPA reviewed the records of the Licensee and her helper. All required forms were in the files of the Licensee and her helper. The Licensee kept up with her Pediatric First Aid and CPR certifications. LPA also met with the Licensee to go over supervision and capacity expectations/requirements. Although the Licensee does not transport children, she understands that children should never be left unattended in vehicles.

According to the Licensee, fire and earthquake drills are conducted and documented twice a year. The last fire and earthquake drill were conducted on 6/2/2022.

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.

LPA discussed the safe sleep regulations with the Licensee and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The
*** See Page 3 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

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: SHEN, YUNHAN	FACILITY NUMBER: 414004119
	VISIT DATE: 08/11/2022

NARRATIVE

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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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reminded the Licensee as of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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

A copy of this report, and the “Notice of Site Visit,” were given to the Licensee.

A “Notice of Site Visit” must remain posted for 30 days.

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

An exit interview was conducted, and the report was reviewed with the Licensee, Yunhan Shen

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

LIC809 (FAS) - (06/04)

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