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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004049
Report Date: 12/08/2021
Date Signed: 12/08/2021 10:01:59 AM

Document Has Been Signed on 12/08/2021 10:01 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LI, YUTINGFACILITY NUMBER:
384004049
ADMINISTRATOR:LI, YUTINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 910-7683
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94132
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: DATE:
12/08/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Yuting LiTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Marie Rodriguez made an unannounced Annual inspection. LPA met with Licensee Yuting Li and explained purpose of inspection. Licensee lives on the first floor of a three story house. Present in home were the Licensee, one helper, and 7 children (3 infants and 4 preschool age). Home is operating within ratio and capacity requirements on this day. All adults working in the home have a criminal record clearance. Hours of operation are Monday to Friday 7:30am to 5:30pm.

Day Care Areas (First floor only):Living room #1, kitchen, half bathroom, and backyard. Off Limit Areas: First floor: Bedroom #1, bedroom #2, bedroom #3, living room #2, and garage. Entire second and third floors of the home. LPA inspected day care areas of home with Licensee. LPA observed the home to be clean and in good repair with proper temperature and ventilation. There are no bodies of water on the property. There is a variety of age appropriate toys and equipment in the home. The backyard is clean and have age appropriate toys and outdoor equipment which are in good condition. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children. There are no firearms or weapons in the home. There is a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available.

Seven children records reviewed were complete. All children have a record of emergency identification information on file. Licensee's Pediatric First Aid/CPR certificate expires August 2022. One staff record reviewed was complete. Last emergency drill was conducted January 2021. Emergency drills are conducted every six months and are properly logged.

No deficiencies cited today under California Code of Regulations, Title 22, Division 12.

(Continued on next page)
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LI, YUTING
FACILITY NUMBER: 384004049
VISIT DATE: 12/08/2021
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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 (US DOJ) 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: http:://www.ada.gov/childqanda.htm.

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 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.

LPA discussed the safe sleep regulations with Licensee 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 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.

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

Exit interview conducted and report was reviewed with Licensee Yuting Li.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021
LIC809 (FAS) - (06/04)
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