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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004729
Report Date: 10/08/2020
Date Signed: 10/08/2020 09:56:39 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:CHOY, RUTH H.FACILITY NUMBER:
414004729
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
10/08/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ruth ChoyTIME COMPLETED:
09:21 AM
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On October 8, 2020 at 9:00 am, Licensing Program Analyst (LPA) Cowan met with applicant Ruth Choy for an announced subsequent Pre-Licensing Inspection. Due to Covid-19, the inspection was conducted via Zoom. The purpose of the inspection is to observe items to be corrected from the initial inspection. During inspection, LPA observed that both doors from the family room leading to the "off-limits" garage have locks installed; Applicants has purchased toys for girls; the lower-level backyard has been fenced from the upper level. Applicant stated that all remaining licensing documents have been mailed to Regional Office on 10/2/20. Upon receipt, LPA recommends licensure for applicant.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2020
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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