414004292-3-21-2022-05-CC-HLEG-CCQQAU-20220321120031

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004292
Report Date: 03/21/2022
Date Signed: 03/21/2022 12:00:46 PM

Document Has Been Signed on 03/21/2022 12:00 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:	LIU, RACHEL C.		FACILITY NUMBER:	414004292
ADMINISTRATOR:	LIU, RACHEL C.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 623-8933
CITY:	MILLBRAE	STATE: CA	ZIP CODE:	94030
CAPACITY:	14	CENSUS: 7	DATE:	03/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Rachel Liu		TIME COMPLETED:	12:00 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 March 21, 2022, Licensing Program Analysts (LPA), Leong, conducted an unannounced annual inspection with Rachel Liu. LPA explained the inspection's purpose to the licensee. During today's inspection, three infants and four pre-k children were in the care of the Licensee, a teacher, and a helper. The fingerprint clearance is on file for all adult residents. The daycare operates from 8:30 am -5:30 pm, Monday through Thursday, 8:30 am – 5:00 pm. Friday. The daycare areas include the Living room, Dining Area, Deck, Bathroom #1, Bedroom #3, portion of the Backyard. The off-limit areas include the kitchen area, Bedroom #1 and Bedroom #2 with Bathroom #2, Garage, portion of the Backyard. All off limit areas are properly barricaded. When a child exhibits symptom of illness, the Licensee will separate the child in the kitchen while contacting the parent to arrange for the child's pick-up LPA and the Licensee conducted an inspection of the daycare areas to look for potential health and safety hazards. The daycare is outfitted with age-appropriate toys and equipment. The home is well-lit, well-ventilated, and free of defects or conditions that endanger children in care. The daycare is equipped with a smoke detector, 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 compounds, detergents, and other items that could endanger children are kept out of reach of children. LPA observed that the fireplace is screened and out of reach of children. Sleeping mats are available for older children to use for napping. Cribs are available for infants to use for napping. LPA saw no walkers, bouncers, or other similar items. The backyard is fenced, clean, and equipped with age-appropriate outdoor equipment. The play structure was surrounded by artificial grass to absorb any child falls. 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 on the property. * 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: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

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: LIU, RACHEL C.	FACILITY NUMBER: 414004292
	VISIT DATE: 03/21/2022

NARRATIVE

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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 homes.

During the inspection, LPA went over all the children's records. Each child has an emergency information card in their file that includes their full name, phone number, and the location of a parent or other responsible adult who can be contacted in an emergency. Each child's file contained parental authorization for the Licensee or registrant to consent to emergency medical care, as well as the child's physician's name and phone number. Every six months, fire and earthquake drills are held, with the most recent drill taking place on 3/1/22.

LPA reviewed the licensee and staff records. The Licensee and both staff members maintain current Pediatric First Aid and CPR certification. Additionally, LPA met with the Licensee to discuss supervision and capacity expectations/requirements. Although the Licensee does not transport children, she is aware that children should never be left in vehicles unattended.

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.

*** 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: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

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: LIU, RACHEL C.	FACILITY NUMBER: 414004292
	VISIT DATE: 03/21/2022

NARRATIVE

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LPAs 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. LPAs 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.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPAs reviewed AB 1207 with 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.

LPAs 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.

LPA reminded the licensee the following documents must be updated in her personnel records
1. LIC 508- Criminal Record Statement
2. LIC 9052-Employee Rights
3. LIC 9108- Statement Acknowledging Requirement to Report Child Abuse

No deficiencies were cited today.

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.

An exit interview was conducted, and the report was reviewed with Rachel Liu

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

LIC809 (FAS) - (06/04)

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