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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004378
Report Date: 07/06/2023
Date Signed: 07/06/2023 11:00:46 AM

Document Has Been Signed on 07/06/2023 11:00 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LU, BAOWENFACILITY NUMBER:
384004378
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 3DATE:
07/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:BaoWen Lu (Angela)TIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Mok conducted unannounced case management for relocating the daycare area temporarily. LPA met with the licensee, the licensee's mother who worked as a helper, and the licensee's 2 minor children. LPA explained the purpose of the inspection to her. There were 3 children with a helper present during the inspection. Per the licensee's request, she wanted to relocate her daycare areas from the lower level to the upper level temporarily because the daycare areas on the lower level will be remodeled for about 3 months, The licensee will keep CCL updated. LPA inspected the upper level for health and safety hazards. The daycare areas will be a living room, open kitchen, and a hallway bathroom only. The off-limit areas will be all the bedrooms, a bathroom in the master bedroom, a garage, an in-law on the lower level, and a backyard. The house was clean and in order. The temperature and lighting were adequate. All toxins and harmful objects were made inaccessible to the children. The licensee installed the soft cushioning to the floor as the soft cushioning in the living room, The fireplace was blocked by a book shelve. The windows in the living room had built-in window locks to limit the windows to be opened up to 4 inches. The licensee also installed extra window locks on the windows. The licensee installed gates at the entrance from the main door and the entrance to the kitchen. All electrical outlets had a built-in childproof blockage. All the lower kitchen cabinets or drawers were either latched or free of harmful objects. The licensee installed the childproof knobs to the stove, bedroom doors, hallway bathroom door, and a door to the lower level. The hallway bathroom was clean and in order. The lower bathroom sink drawers were free of harmful objects. There was a fully charged 2A10BC fire extinguisher, and working smoke and carbon monoxide detectors in the hallway.

The following items must be completed before the approval:
  • Install a lock or hook to the gate between the living room and kitchen area.

This report and notice of the site visit were discussed with the licensee and must be made available to the public upon request. For quarterly updates on Licensing information, go to the 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: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2023
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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