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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001466
Report Date: 05/02/2022
Date Signed: 05/02/2022 02:45:45 PM

Document Has Been Signed on 05/02/2022 02:45 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:YANG, HUI XINFACILITY NUMBER:
384001466
ADMINISTRATOR:YANG, HUI XINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 387-7829
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
05/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Hui Xin YangTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Hui Xin Yang and her helper who has fingerprint clearance. The purpose of the inspection was explained to her. There were 9 children that included 2 infants with a staff present. The children were napping upon LPA arrival. The facility was toured and inspected for health and safety hazards. There are two bedroom, 1 bathroom, a living room, dining/kitchen area in this home. The whole unit was used for day care children. Current residents of the home was licensee only.. The home was clean and orderly. Day care had a working telephone. a fully charged 2A10BC fire extinguisher, and first aid supplies available. Per licensee, there is no pet, no firearms or weapons in the home. There were children's toys and equipment available for children in the day care area and all appeared to be safe and age appropriate for children. The licensee installed the soft cushioning to the daycare floor to prevent injury. The windows were barricaded in the living room and dining room. The childproof konbs were installed to the stove. The children's bathroom was clean adn free of harmful object. The outdoor play area was completely fenced. There were some outdoor toys and play structure available for the children. If there were ill child, Licensee would place them in one of the bedroom while waiting for parent to pick them up. Licensee and her helpers' CPR and First Aid training were current. They will expire 1/30/2023. Parents rights poster, disaster plan and the License are also posted. Licensee provides meal to children. Disciplinary policy was discussed with licensee today. Per Licensee, she has purchased liability insurance for her day care. Fire/disaster drills were conducted monthly and was logged. Per licensee, there were no children on special medication.. All the required postings were posted. LPA reviewed the staff and children's files during the inspection. LPA also obtained a copy of the current children roster. The licensee and helper had updated Child Abuse Mandated Reporter (AB1207), they will expire on 4/16/2024.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update 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: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2022
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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