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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004049
Report Date: 07/17/2020
Date Signed: 08/31/2020 11:00:23 AM

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:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
07/17/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Yuting LiTIME COMPLETED:
12:30 PM
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LPA Haydee Caliboso met with licensee Yuting “Ellen” Li for increase in capacity requested by the licensee via Zoom. Due to COVID-19 outbreak and current shelter in place orders in the State of California and San Francisco County, the inspection of increase in capacity was conducted via tele-inspection on 7/17/20.

The licensee stated that she is living in the home alone. The facility is currently operating. Present during today’s inspection was a nine-year-old child and a fifteen-month-old child. Licensee is operating within capacity requirements on this day. The hours of operations are from Monday-Friday, 7:30AM – 5:30PM. The licensee’s home is clean, orderly, and equipped with age-appropriate toys for children. The licensee will provide care in the following areas (first floor only): Living room #1, kitchen, half bathroom, and backyard. Off limit areas: Bedroom #1 (located in the first floor), garage, and entire second and third floors of the home. LPA observed that the half bathroom cabinet where cleaning supplies were stored did not have a child proof lock. LPA reminded the licensee that all cleaning supplies, chemical, and toxic supplies must be stored in a locked cabinet and made inaccessible to children. LPA discussed with the licensee that all sharp utensils such as knives must be stored in a locked cabinet and made inaccessible to children. The backyard is completely gated and fenced off. There is a fully charged fire extinguisher, a working smoke detector, and a carbon monoxide (CO) detector in the home. Home does not have a swimming pool, spa, hot tub, fishpond, or any other bodies of water, weapons, or firearms.



Continuation 809-C
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R CalibosoTELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2020
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 2
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: 07/17/2020
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Licensee stated that her First Aid CPR has expired and is scheduled to obtain a current First Aid CPR. Capacity limits for a large family day care has been reviewed with the licensee. Licensee was reminded that when operating at a large capacity, there must be a helper present. Capacity limit resource was provided to the licensee.

Prior to approval of capacity increase; Licensee shall complete and submit verification of the following:
· A proof of child proof lock installed in the bathroom.
· Current First Aid CPR
· A proof of designated area for all necessary information are posted and available for families.
· Fire approval from San Francisco County.

This report must be available in the facility for public review. Notice of site visit was observed being posted. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov




SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R CalibosoTELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2