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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001750
Report Date: 01/22/2025
Date Signed: 01/22/2025 04:46:42 PM

Document Has Been Signed on 01/22/2025 04:46 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:LAU, CHUK SHANFACILITY NUMBER:
384001750
ADMINISTRATOR/
DIRECTOR:		LAU, CHUK SHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 713-3838
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
01/22/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Chuk Shan LauTIME VISIT/
INSPECTION COMPLETED:
04:57 PM
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On January 22 2025, Licensing Program Analysts (LPAs) Naves and Van performed an annual inspection, which included checking the interior and exterior of the home and discussing the required childcare paperwork with the Licensee. LPAs met with the Licensee Chuk Shan Lau. The purpose of the inspection was explained, and the Licensee granted LPA entry to the home. The licensee and 2 helpers supervised 11 children today: eight preschoolers and three infants. Children's capacity and ratio criteria were in compliance.

LPAs observed eleven children napping upon arrival on mats. The 15-minute sleep logs for infants were checked, and it was noted that the licensee had accurately documented the logs, including the date, 15-minute increment of each check, and staff initials.

There were no changes to the previously approved childcare or off-limit areas. The Childcare areas are the ground floor, including the playroom/classroom two bathrooms and backyard. Off-limit areas are the entire second floor and garage. All off-limit childcare areas have been appropriately blocked off from the children. Days and operations are from Monday through Friday, from 8:00 am to 6:00 pm. The Licensee has valid childcare liability on file through Acord.

LPAs inspected the facility's indoor and outdoor environments for health and safety hazards. The childcare area is well-maintained and neatly organized, with playthings and equipment tailored to the children's ages. The house is well-lit and ventilated, with a functional phone and a combination carbon monoxide & smoke detector. A 2A10BC fire extinguisher was undercharged licensee brought out brand-new one she had just purchased. A fully stocked first aid kit is available. The licensee stated that there are no bodies of water on the property and that daycare children have no access to any cleaning products or hazardous chemicals. The licensee confirmed that there were no guns or any weapons in the house.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jaclyn Naves
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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: LAU, CHUK SHAN
FACILITY NUMBER: 384001750
VISIT DATE: 01/22/2025
NARRATIVE
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The Licensee and helpers all have valid Pediatric First Aid certification currently valid. In addition, the Licensee and helper maintained up-to-date mandated reporter training and a complete immunization record. Emergency drills are conducted once every other month, with the most recent drills completed on 1/9/2025. Per the Licensee, she offers breakfast, lunch, dinner, and afternoon snacks to children.

All children’s files were reviewed. The Licensee maintains complete records of all children in care, including vaccination records and Parental Rights forms. LPAs observed that each kid had a complete emergency information card that included the child's full name, phone number, and the location of a parent or authorized person who may be called in an emergency. LPAs discussed care and supervision with the Licensee. There is no transportation provided.

Capacity options were reviewed, and the Licensee acknowledges that care cannot be provided over the capacity specified on the license. The requirements for reporting suspected child abuse, as well as reporting requirements for unusual incidents, were discussed. All mandatory postings (License/Parent's Rights poster/Emergency Disaster Plan and Earthquake Preparedness Checklist) are posted.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.




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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jaclyn Naves
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: LAU, CHUK SHAN
FACILITY NUMBER: 384001750
VISIT DATE: 01/22/2025
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LPAs discussed the safe sleep regulations with the Licensees and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed the 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 Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: www.ada.gov/childqanda.htm.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPAs reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jaclyn Naves
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: LAU, CHUK SHAN
FACILITY NUMBER: 384001750
VISIT DATE: 01/22/2025
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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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

During the exit interview, the LICENSEE, Chuk Shan Lau, confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

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

An exit interview was conducted, and the report was reviewed with the licensee, Chuk Shan Lau.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jaclyn Naves
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
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