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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004511
Report Date: 10/12/2023
Date Signed: 10/12/2023 05:17:28 PM

Document Has Been Signed on 10/12/2023 05:17 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:LI, JIN ZHUFACILITY NUMBER:
384004511
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
10/12/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Jin Zhu LiTIME COMPLETED:
05:30 PM
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On October 12, 2023., Licensing Program Analyst (LPA) Van met with Licensee Jin Zhu Li for an unannounced case management inspection. The inspection aimed to process a capacity increase requested by the Licensee. Present at the inspection are four children with the Licensee and her husband (two infants and two preschoolers). The hours of operation are Monday through Friday, 8:00 am – 5:00 pm.

LPA inspected the facility for health and safety hazards. Currently, the childcare areas are the living room, bathroom on the second floor, and backyard. The off-limit areas are all four bedrooms, a kitchen, a dining area on the second floor, and a garage. However, as part of the capacity increase, the licensee decided to move the childcare area to the ground floor and make the whole second floor off-limits. The Fire marshal has inspected childcare on the ground floor and approved the fire clearance. The new childcare areas on the ground floor consist of a large room and a bathroom. The childcare areas are clean and have age-appropriate toys and learning materials. There is age-appropriate furniture, which is sturdy and in good repair. The facility floor is in good repair and free of any hazards. The children's bathroom is in good working condition with proper sanitation. All the materials and surfaces accessible to children are clean and toxins-free. The facility has no pools, spas, or other bodies of water. The facility has a smoke detector, carbon monoxide detector, fully charged fire extinguishers, and a working telephone. All the cleaning solutions, poisons, and other chemicals that are dangerous to the children are stored and inaccessible to the children.

The San Francisco Fire Department has granted the fire clearance on September 27, 2023.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2023
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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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: LI, JIN ZHU
FACILITY NUMBER: 384004511
VISIT DATE: 10/12/2023
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During the inspection, the following was discussed and reviewed with the Licensee:
· Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
· Incidentals Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm
· The Licensee was given information regarding PIN 20-24-CCP Safe Sleep Regulation
· The Licensee was reminded that as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.622.
· The Licensee was reminded about Mandated Reporter training available on the CCLD website. Training must be completed every two years by all staff hired. Training can be taken online at www.mandatedreporterca.com. If training is unavailable in the native language, a statement can be written stating exemption until the translation is available.
· The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website.
· Mandatory Posting Requirements: License, Emergency Disaster Plan, and Notification of Parents Rights Poster.
· The capacity limit of a Large License was discussed with Licensee. The Licensee was reminded that a Helper must be present when operating at a large capacity. In addition, Pediatric FirstAid CPR is required for all helpers.

The licensee provided proof of control of property.

A recommendation to increase the capacity of a large family childcare home will be made once the licensee purchases and installs additional beveled edge cushions to prevent children from tripping. Pictures of the completed installation can be sent to LPA via email.

Today's report and site visit notice were provided to the Licensee. LPA informed the Licensee that a site visit notification must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
LIC809 (FAS) - (06/04)
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