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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004693
Report Date: 03/23/2021
Date Signed: 03/23/2021 10:05:00 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:KUO, WAN YUFACILITY NUMBER:
414004693
ADMINISTRATOR:KUO, WAN YUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 380-8555
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:14CENSUS: 2DATE:
03/23/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Wan Yu KuoTIME COMPLETED:
09:00 AM
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Due to COVID-19 and DPH guidelines of social distancing, Licensing Program Analyst (LPA) Winnie Ly conducted a Case Management via FaceTime on March 23, 2021 at 8:30am with applicant Wan Yu Kuo (aka Alice). Licensee initiated the inspection to add the backyard to her Family Child Care. Present at the home during the tele-inspection was applicant, an assistant and two children.

During the tele-inspection, the Licensee gave the LPA a tour of her daycare facility including the backyard. The backyard is completely fenced in with all hazardous materials and items being put away and kept out of the reach of the children. There are play structures and toys available to the children. Licensee also stated there will always be at least two assistants available in the back yard to assist the children. LPA observed a swing and Licensee was advised children should be supervised at all time if swing is made assessable to children. Licensee stated she will always have an adult accompany any children who want sit on the swing.

Based on the inspection conducted on 03/23/2021, LPA is recommending the backyard for licensure and to be a part of the day care areas.

This report was completed in the San Bruno Regional Office and the report was emailed to the licensee.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2021
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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