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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000267
Report Date: 09/10/2024
Date Signed: 09/10/2024 10:05:18 AM

Document Has Been Signed on 09/10/2024 10:05 AM - 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CHENG, SANDY & ZHENG, SU QUINGFACILITY NUMBER:
384000267
ADMINISTRATOR/
DIRECTOR:		CHENG, SANDY & ZHENG, SUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 564-6688
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
09/10/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Sandy ChengTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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On September 10, 2024 at approximately 8:30am, Licensing Program Analyst (LPA) Ly conducted an Unannounced Plan of Correction (POC) Visit and met with Licensee, Sandy Cheng during the visit. Purpose of the inspection was explained. There were 2 children in care upon LPA arrival. An Assistant arrived at 9:30am. Total in care by the time inspection completed was 7 preschool age children and 2 infant age children.

The POC visit is regarding Type A deficiency cited on 08/2/2024:
1. If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible. Based on interview of Licensee, infant had to be held or carry on carrier during nap time. Licensee was advised all infants must be placed in a crib or play yard for nap.

During today's visit, LPA observed an infant crib has been put in place in the nap room for infant. Type A deficiency is cleared on this day. Letter of deficiency clearance has been provided to Licensee during today's visit.

Also cited on 08/28/2024, the following Type Bs were being cited:
1. Assistant does not have required licensing forms on file.
2. Assistant did not have proof of immune to Measles and Tuberculosis Clearance.
3. Infant in care did not have required Individual Infant Sleeping Plan (LIC 9227).
4. The provider shall physically check on the infant every 15 minutes and document infant's nap.


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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CHENG, SANDY & ZHENG, SU QUING
FACILITY NUMBER: 384000267
VISIT DATE: 09/10/2024
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During today's visit, LPA reviewed Assistant's file. Assistant's file is complete with proof of immunization, Tuberculosis clearance and required licensing forms. LPA also reviewed infant's files and found file has Individual Infant Sleeping Plan (LIC 9227) and provider has infant nap log documenting infant's nap every 15 minutes. LPA cleared the Type Bs deficiencies cited on 08/28/2024 and issued a letter of clearance to Licensee. .

A copy of this report and appeal rights were discussed and left with Licensee whose signature on this form confirm receipt of reports. Notice of Site Visit was provided to licensee. Licensee was advised Notice of Site Visit to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC809 (FAS) - (06/04)
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