414004563-5-8-2019-05-CC-BVAN-BBYPPD-20190508112919

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004563
Report Date: 05/08/2019
Date Signed: 05/08/2019 11:29:29 AM

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:	WU, JOYCE		FACILITY NUMBER:	414004563
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	05/08/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Joyce Wu		TIME COMPLETED:	11:30 AM

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	Licensing Program Analysts (LPAs) Van and Singh met with applicant, Joyce Wu, for a scheduled pre licensing inspection for capacity increase and relocation. Applicant has family child care home operating at previous location (414004420). Days and hours of operation will be Monday-Friday 8AM - 6PM. Applicant states that she lives with her minor child. Licensee owns the home control of property documents verified and are in file. The entire home is inspected for health and safety hazards. This is a 3 bedrooms and bathroom home. Day-care areas are the living room, dining room, bathroom, bedroom next to the living room, and backyard. Kitchen and garage will be used as walk way for children to access the backyard. Off limit areas are front yard, master bedroom, and bedroom next to the bathroom. There is a fully charged fire extinguisher that meets minimum requirements. Smoke detector and carbon monoxide (CO) detector were checked and are working. Home has proper lighting and ventilation. Per applicant, there are no firearms, weapons, or pets in the home. Per applicant, there will be pets. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. There are sufficient age appropriate toys and children's equipment in the day care. . Applicant will use bedroom next to the living room as an isolation area while waiting for parent to pick up. As applicant is running a day care, applicant is aware of forms and procedures. LPAs discussed the ratio and capacity requirements with the applicant and a handout was provided. Continue on the next page...................

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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: WU, JOYCE	FACILITY NUMBER: 414004563
	VISIT DATE: 05/08/2019

NARRATIVE

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Continuation from previous page..............

Before granting license, following is required:

- Fireplace need to be barricade to prevent access from children.
- All unused electrical outlets must have protective cover.
- Gate must be installed between the kitchen door and the hallway.
- All furniture need corner cushion.
- Approved fire clearance from local fire department.

Copy of this report is reviewed and provided to the applicant. A follow up inspection will be made to verify the correction.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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