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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004483
Report Date: 05/03/2023
Date Signed: 05/03/2023 10:45:42 AM

Document Has Been Signed on 05/03/2023 10:45 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:LI, SUSANNA YANNAFACILITY NUMBER:
384004483
ADMINISTRATOR:LI, SUSANNA YANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 218-0633
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
05/03/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Susanna Yanna LiTIME COMPLETED:
11:00 AM
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Licensing Program Analyst, LPA Yee conducted a case management visit today. Present at the daycare are two helpers and seven children (4 infants). The licensee arrived at the facility within 5 minutes. Roster was reviewed. The licensee requested to add her backyard. LPA inspected the backyard. The backyard needs general clean up. The facility may submit photos for approval from CCL.

The capacity worksheet was provided and explained.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2023
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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