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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004693
Report Date: 02/03/2022
Date Signed: 02/03/2022 02:20:30 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:KUO, WAN YUFACILITY NUMBER:
414004693
ADMINISTRATOR:KUO, WAN YUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 380-8555
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:14CENSUS: 9DATE:
02/03/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Wan Yu KuoTIME COMPLETED:
02:30 PM
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On February 3, 2022 at 12:55pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted a case management inspection. LPA met with licensee, Wan Yu "Alice" Kuo and explained the purpose of the inspection. Licensee requested to add 2 additional rooms, previously labeled "Off-limits" to day care areas.

Present in the home were licensee, licensee's spouse, licensee's helper, licensee's minor child and 9 enrolled children (2 infants and 7 preschoolers). Licensee is operating within capacity requirements on this date. All adults living or working in the home have a criminal record clearance on file. Hours of operation are Monday to Friday from 8:00am to 6:00pm.

Licensee rents the multi-level, single family home. Home consists of 3 bedrooms, 2 bathrooms, 2 living rooms (1 in front of the home and 1 in the back of the home), dining area (office), quiet room, kitchen, backyard and garage. All guests enter the home through the side gate on the side of the house. The DAY CARE AREAS now approved are the living room #1(located in the back of the home), quiet room (located next to living room #1) bathroom #1, bedroom #1 (located next to bathroom #1), and backyard. The OFF-LIMITS AREAS are living room #2 (located in the front of the home), bedroom #2, bedroom #3, dining room, kitchen, and garage. All off limit areas are made inaccessible to children by child safety gates and/or child proof locked door knobs.

LPA observed a variety of age appropriate toys and equipment in the home which were in good condition. Quiet room and play room have functioning smoke and carbon monoxide detectors. Accessible cabinets children are not to access have child safety locks installed.

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SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
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 2
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: KUO, WAN YU
FACILITY NUMBER: 414004693
VISIT DATE: 02/03/2022
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Licensee was reminded that her own children under 10 must be included in ratio of day care. LPA reviewed capacity and ratios of small and large license. Licensee was reminded that when she is working alone, licensee must operate as a small license. Licensee was reminded that when operating at a Large capacity, there must be a helper present.

Licensee was reminded that all adults and older living or working in the home, including employees, 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed 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.

After today's inspection, no deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted and report was reviewed with the licensee, Wan Yu "Alice" Kuo.

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
LIC809 (FAS) - (06/04)
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