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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004602
Report Date: 08/01/2019
Date Signed: 08/01/2019 03:16:39 PM

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:YEN, LING K.FACILITY NUMBER:
414004602
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
08/01/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ling K. YenTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analysts, LPAs Yee, and Interiano conducted a scheduled pre-licensing inspection today. Present in the home are applicant, Ling K. Yen aka "Grace" and Wonder School Representative, Nicki Whear. LPAs inspected the home with the applicant, Ms. Yen. Current residents are Grace, her husband, her mom, one tenant and their two daughters ages 3-years-old, one year old. The home is owner-occupied. The home consists of 5 bedrooms, 3 full bathrooms, office, backyard. Daycare area (s): living room, bedroom #2, bedroom #3, hallway bathroom, and portion of the backyard. The remaining areas are off-limit. Kitchen is gated to prevent children from access. The home is equipped with a working smoke alarm, carbon monoxide detector and a fully charged fire extinguisher which is at least size 2A10BC. All harmful objects, sharp objects and toxic are stored out of reach of children. Applicant states there are no pets, guns or weapons in the home. The home is clean and orderly. LPAs advised the applicant to conduct an emergency drill once every 6 months and keep a log sheet. The home has age-appropriate toys and equipment available for the children in care. LPAs reminded the applicant that infant walker, exersaucers, jumpers, bouncers and any similar items are not allowed in the daycare areas. Required immunization for the staff is on file. The applicant has 8 hours of health and safety certificate on file. CPR & 1st aid certificate is current until 6/2021. The applicant has been advised all adults, 18 yrs and older living in the home, or helper must have fingerprint clearance prior to having any contact with children in care. LPAs discussed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/ AB1207 for the applicant is on file. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, an Plan for Providing IMS must be submitted to the Department. The 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
A packet of records to be maintained is left and explained to the applicant. Posting requirements are also discussed and explained. Capacity for a small FCCH was explained. SIDS information was explained and provided.

LPA will recommend this applicant for a small license effective today 08/01/19.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
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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