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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004338
Report Date: 04/12/2022
Date Signed: 04/12/2022 01:54:21 PM

Document Has Been Signed on 04/12/2022 01:54 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:CHULUUN,SARANFACILITY NUMBER:
384004338
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
04/12/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Saran ChuluunTIME COMPLETED:
02:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mok conducted an unannounced POC inspection. LPA met with the licensee, Saran Chuluun, and her helper. The purpose of the inspection was explained to her. There were 4 children that included 2 infants with a helper present. The POC inspection was related to the deficiency that was cited on 4/6/2022 for over capacity. LPA toured the facility for health and safety hazard. The licensee reduced the number of the children within the capacity. The deficiency dated on 4/6/2022 was cleared during the inspection.















This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2022
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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