<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002600
Report Date: 01/04/2022
Date Signed: 01/04/2022 03:55:09 PM

Document Has Been Signed on 01/04/2022 03:55 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:YAN, MEI RONGFACILITY NUMBER:
384002600
ADMINISTRATOR:YAN, MEI RONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 278-1033
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
01/04/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Mei Rong YanTIME COMPLETED:
02:30 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
Licensing Program Analyst, LPA Yee conducted a required-1 year inspection today. The purpose of the inspection was explained. Present at the facility are licensee, Mei Rong, her daughter(helper), and 8 children. Licensee's daughter, Irene is helping her temporarily. Current residents are licensee, Mei Rong, and her mom. The facility personnel summary report was reviewed with Mei Rong, she said it's correct. Daycare areas (upper level): living room, family room, kitchen, bathroom, and backyard. The remaining areas of the house are off-limits. The off-limit areas are barricaded from children accessing the areas. The facility has a fully charged fire extinguisher, a smoke detector, and a carbon monoxide detector. Children roster and staff files were reviewed. The licensee has current CPR & 1st aid until 2/2022. Required immunization for licensee and staff members are on file. LPA discussed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/. Licensee has current AB1207 until 3/6/23. Licensee's daughter(helper) record is not on site. Some information (MMR, AB1207) for helper, WanMing is missing. The licensee said she will check with her daughter, Irene, and helper, WanMing, and will submit it to CCL ASAP. LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

Forms and website: www.ccld.ca.gov. Title 22, Div 12, Chp 3

Office: (650) 266-8800
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 01/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/04/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1