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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004729
Report Date: 05/13/2021
Date Signed: 05/13/2021 03:46:02 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:CHOY, RUTH H.FACILITY NUMBER:
414004729
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
05/13/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ruth ChoyTIME COMPLETED:
03:12 PM
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On 5/13/21 at 2:00 PM, Licensing Program Analyst (LPA) Cowan met with licensee for an announced case management inspection. The purpose of the inspection was explained. Due to Covid-19 State of Emergency, the inspection was conducted via Facetime. Present in the facility is licensee, helper, and five children. This inspection is a result of a request sent to the Regional office requesting to add bedroom 4 to the day care area for napping only.

LPA toured the day care area and observed that day-care area is clean, and home has proper lighting and ventilation. LPA inspected bedroom 4. The room was clean and spacious. LPA did not observe any harmful objects or substances. Licensee states that she will buy playpens for napping for infants. Based on visuals, LPA approves bedroom 4 for napping.

Child care areas are now the lower level bedroom 3 and 4, family room, bathroom 3, and lower level back yard.

This report is emailed to licensee with a request for reply demonstrating receipt.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2021
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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