<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004602
Report Date: 08/05/2021
Date Signed: 08/05/2021 04:27:38 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:YEN, LING K.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 288-8818
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY:14CENSUS: 7DATE:
08/05/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Yen, Ling KTIME COMPLETED:
11:00 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 Analyst ( LPA) Jyoti Saini met with Licensee, Ling Yen for an unannounced Annual Random Inspection. This facility is under Title 22 of the California Code of Regulations. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during this inspection was Licensee and her helper taking care of 4 infants, 3 preschool aged children. The hours of operation are 8:30 AM-5:30 PM, Monday -Friday.
On-limit-areas are the Living room, bedroom #2, bedroom #3, hallway bathroom, and portion of the backyard.
Off-limit-areas are the: entire first floor, the master bedroom on third floor and the garage.
LPA observed the following: Daycare Area is clean, orderly, and equipped with age appropriate toys and equipment for children, indoors and outdoors. Home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. There are no bodies of water in the day care. The Fireplace in the Daycare area is properly barricaded. There are child size tables and chairs for snack and activities. There are ample of age appropriate toys that appear to be safe and in good condition. The napping room had cots in good condition and each child have their separate blankets. All trash cans and recycle bins have tight fitted lids. Licensee states there are no guns or weapons of any kind in the home.

Licensee and helper’s CPR expires in 06/2023. Licensee conducted last emergency drill on 04/20/2021 and is properly logged. Licensee provides daily snacks and meals. Discipline policy is redirection. LPA reviewed children’s files. All required postings are properly posted.


During inspection, Licensee was informed that All 18 years and older adults living in the home or working at the house must have fingerprint clearance before contacting the children.
· Licensee was informed about safe sleep, individual infant sleeping Plan, the Provider Information Notices (PINs) on CCLD website.
· Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

>No deficiencies were cited today under Title 22 Division 12 of the Ca. Code of Regulations.

> This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit.
This report will be emailed to licensee Yen Ling at her email address graceyen@me.com by close of business 08/05/2021 with a request for reply showing proof of receipt.
Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1