414004729-10-10-2023-05-CC-CQUO-CWGTGJ-20231010144312

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004729
Report Date: 10/10/2023
Date Signed: 10/10/2023 02:43:18 PM

Document Has Been Signed on 10/10/2023 02:43 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CHOY, RUTH H.		FACILITY NUMBER:	414004729
ADMINISTRATOR:	CHOY, RUTH H.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 315-6825
CITY:	BELMONT	STATE: CA	ZIP CODE:	94002
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 12	DATE:	10/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Ruth Choy		TIME COMPLETED:	03:15 PM

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	On October 10, 2023 at approximately 12:55pm, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an unannounced, annual inspection. LPA met with licensee, Ruth Choy, and explained the purpose of the inspection. Present during LPA's visit included licensee, licensee's spouse and 12 enrolled children (4 infants and 8 preschool age). Hours of operation are Monday through Friday. 7:30am to 5:30pm. Entrance to the facility is through side gate. Licensee lives in the multi-level home with their spouse and minor children. All adults living in the home have fingerprint clearance on file. The DAY CARE AREAS are located on the lowest level of the home only that includes den (napping room), bedroom #3, family room, bathroom #3 and lower level backyard. The OFF LIMIT AREAS are the entire second level of home and upper level of backyard. Off limit areas and staircase in the home are made inaccessible with child safety gates. LPA toured day care areas of home with licensee. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good condition. LPA observed electrical outlets to be made inaccessible with child safety covers. Cleaning supplies, poisons and hazardous materials are stored in home's high shelves and/or locked behind child safety locked cabinets. Home is equipped with a fully charged fire extinguisher, fire alarm, smoke detector and carbon monoxide detector. Smoke and carbon monoxide detectors were tested during visit and both were observed to be in working condition. Den (napping room) was observed to be equipped with cots for napping children. Cribs utilized for infants were observed to be free of loose articles, bumper pads and pillows. LPA observed cribs to have mattresses with tight fitting sheets. Licensee maintains sleeping logs for napping infants. Sleeping logs document the 15 minute time check of when infant was last checked on. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHOY, RUTH H.	FACILITY NUMBER: 414004729
	VISIT DATE: 10/10/2023

NARRATIVE

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Bathroom was observed to be in proper working condition. There is appropriate sanitation and toileting equipment for children in care. Cabinets and drawers in bathroom were observed to have child safety locks installed.

Outdoor area is entirely enclosed and fenced. Flooring in outdoor area was observed to be cushioned with artificial turf. Outdoor area includes a variety of toys and equipment that were in good condition. Off limit backyard area includes a child safety gate. LPA did not observe any pools, spas or bodies of water on site.

LPA reviewed 6 random children's records which were complete. Children's files have record of identification emergency information and past sleeping logs for infants. LPA reviewed licensee and licensee's spouse's records which were also complete. Licensee and spouse have current CPR/First Aid certifications and current Mandated Reporter certifications. Licensee's CPR/First Aid certification will expire 09/2024.

Licensee conducts and documents emergency disaster drills appropriately. Last disaster drill was conducted 09/20/2023. LPA observed required licensing documentation to be properly posted, made available for review. Licensee maintains a child care roster that was also made available for review. Per licensee, there are no weapons or firearms in the home.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working
in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHOY, RUTH H.	FACILITY NUMBER: 414004729
	VISIT DATE: 10/10/2023

NARRATIVE

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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-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a
consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee, Ruth Choy, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were issued during today's visit.

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

Exit interview conducted and report was reviewed with the licensee, Ruth Choy.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

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