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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004338
Report Date: 03/04/2025
Date Signed: 03/04/2025 05:39:27 PM

Document Has Been Signed on 03/04/2025 05:39 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CHULUUN,SARANFACILITY NUMBER:
384004338
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
03/04/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:45 PM
MET WITH:Saran Chuluun TIME VISIT/
INSPECTION COMPLETED:
05:45 PM
NARRATIVE
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On March 4, 2025, Licensing Program Analysts (LPAs) Leong and Badger conducted an unannounced annual visit. LPAs met with the Licensee, Saran Chuluun, and explained the purpose of the visit.

Today’s visit included one pre-k child and two infants. The licensee has a small license and is operating within the capacity limits and ratios for this visit.

According to the licensee, four children are enrolled in her daycare. All four children’s info was accounted for on the children’s roster.

LPAs observed that all required documents, such as the facility license, the Notification of Parental Rights, and the Earthquake Preparedness Checklist, were displayed and visible to the public.

According to the licensee, an emergency disaster drill was completed in December 2024, but she did not document it. LPA issued a technical violation to the facility for not meeting the requirement mentioned above.

Daycare Areas: Living room, Dining room, Bedroom #1 (napping only), Backyard, and Bathroom.

Off-limits areas: Bedroom #2 and the laundry room. The door to these areas was fitted with a child safety doorknob. The licensee understands that off-limits areas may not be used for childcare during business hours.

LPAs inspected the indoor and outdoor daycare areas to identify health and safety hazards. The home had a fully charged fire extinguisher, a first aid kit, a carbon monoxide detector, and a smoke detector. LPAs tested the carbon monoxide and smoke detector and found them functioning.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CHULUUN,SARAN
FACILITY NUMBER: 384004338
VISIT DATE: 03/04/2025
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LPAs observed that the home's interior was clean and orderly. Disinfectants, cleaning solutions, poisons, and other hazardous items were stored in areas inaccessible to children. The bathroom was clean, fully operational, and equipped with suitable toileting equipment and sanitation products.

LPAs observed that the daycare areas had age-appropriate toys, furniture, and educational materials. Electrical outlets were fitted with child safety covers to prevent children from accessing them.

The licensee stated that no firearms or weapons were present on the property.

The backyard is surrounded by a fence and features a variety of outdoor play equipment, all of which are in excellent condition. LPAs did not observe any pools, spas, or bodies of water on the property.

The licensee stated that she currently provides breakfast, lunch, and snacks for the children and that none of the enrolled children have documented allergies.

The facility offers different options for children to rest or nap, including cribs and playpens. LPA observed that sheets and blankets were available for the children. Infant mattresses are firm and equipped with appropriately sized sheets. All playpens and cribs are well-maintained and free of loose items that could pose safety risks.

LPA reviewed the files of three children. The children's files contain records of emergency identification information and necessary immunizations. All three children's files were missing form LIC 282, and two children’s files were missing LIC 995A. Two technical violations were issued for missing required forms from the children’s files.

LPA reviewed the 15-minute sleep records for the two children under two and confirmed they were documented.

LPA reviewed the licensee’s files and confirmed that she had a complete record. The licensee’s Pediatric First Aid/CPR certification will expire in June 2025, and her Mandated Reporter certification will expire in March 2025.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CHULUUN,SARAN
FACILITY NUMBER: 384004338
VISIT DATE: 03/04/2025
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Licensee was reminded that all adults 18 and over living or working in the 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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/.

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.

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.

During the exit interview, the licensee, Saran Chuluun, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

TECHNICAL VIOLATION: Violations of the Health and Safety Code (HSC), regulations (CCR), or interim licensing standards (ILS) that do not pose a health, safety or personal rights risk.

No deficiencies were issued today during LPA's visit.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Saran Chuluun.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
LIC809 (FAS) - (06/04)
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