384004332-5-14-2024-05-CC-CMOK-D59VH2-20240514162624

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004332
Report Date: 05/14/2024
Date Signed: 05/14/2024 04:27:12 PM

Document Has Been Signed on 05/14/2024 04:27 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	LIU,LI XING		FACILITY NUMBER:	384004332
ADMINISTRATOR/ DIRECTOR:	LIU,LI XING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 802-6130
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94134
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 10	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:15 PM
MET WITH:	Li Xing Liu		TIME VISIT/ INSPECTION COMPLETED:	04:55 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) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Li Xing Liu, and a helper who had fingerprint clearance. LPA explained the purpose of the inspection to them. The licensee and a helper are Primary Chinese Speakers. The licensee speaks fluent Cantonese. There were 10 children including 2 infants with a helper present. The licensee owns and lives with her husband and son in this 2 stories single-family house. The house has 2 bedrooms, 1 and a half bathrooms, a kitchen, dining room, and living room on the upper level; on the ground level with a play area, dining area with open kitchen, 2 bathrooms (children and adults), a backyard, and a garage. The daycare areas are the entire lower level and a backyard. The off-limit areas are the entire upper level and a garage. The facility's operation hours are Monday to Friday from 8 AM to 6 PM. LPA inspected the facility for health and safety hazards. The main entrance of the facility is located on Goettingen Street. The facility was clean and in order, temperature and lighting were adequate, and toxins and harmful objects were made inaccessible to the children. There were plenty of age-appropriate toys, books, learning materials & equipment, and children's furniture that were in good condition and repaired. The licensee installed soft cushioning on the entire floor in the main play area. The licensee installed gates at the stairways and entrance of the main play area to prevent children from accessing the off-limit areas. There was a fully charged 2A10BC fire extinguisher a working cellular phone, a working 2in1 smoke and carbon monoxide detector, and first aid supplies available. The right amount of cubbies was available by the entrance of the play area for the children to store their personal belongings. Boosters were available for feeding only. Mats and cribs were used for napping. The children's bathroom was clean and in order. LPA did not observe any harmful objects in it. The outdoor play area was completely fenced and clean. The facility provides breakfast, AM/PM snacks, lunch, and dinner to the children. Per the licensee, she has no guns, weapons, or pets in the house, and no children on Special medication either. The licensee installed door chimes at the backdoor and side door to the outdoor play yard. The licensee and her helper had current CPR/First Aid Training that will expire on 5/2025 & 3/2025, and Child Abuse Mandated Reporter Training that will expire on 11/2025 & 9/2024. The licensee posted all the required postings. LPA reviewed the children's files and obtained a copy of the children's roster during the inspection. continues in LIC809C

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LIU,LI XING	FACILITY NUMBER: 384004332
	VISIT DATE: 05/14/2024

NARRATIVE

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Criminal Record Clearance - Licensee was reminded that all adults 18 and over living or working in home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Safe Sleep - 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-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LIU,LI XING	FACILITY NUMBER: 384004332
	VISIT DATE: 05/14/2024

NARRATIVE

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

Megan’s Law - During the exit interview,Li Xing Liu , confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the licensee, Li Xing Liu.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

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