384004511-1-24-2024-05-CC-BVAN-CZT344-20240124165432

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004511
Report Date: 01/24/2024
Date Signed: 01/24/2024 04:54:39 PM

Document Has Been Signed on 01/24/2024 04:54 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	LI, JIN ZHU		FACILITY NUMBER:	384004511
ADMINISTRATOR:	LI, JIN ZHU		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 298-7005
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	01/24/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Jin Zhu Li		TIME COMPLETED:	05:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 24, 2024., Licensing Program Analyst (LPA) Van conducted a required inspection and met the Licensee, Jin Zhu Li. LPA explained the purpose of the inspection to the Licensee and was given access to the home. The licensee and her husband supervised seven children today: three preschool-aged children and four infants. The Licensee complies with the licensing capacity and limits today. All adults present during the inspection have cleared criminal clearance verified with the CDSS Guardian site. There are no changes to the childcare areas previously approved, with the same off-limits and childcare areas. The childcare area is provided on the first level only, consisting of a large room, a bathroom, and a backyard. Off-limit areas are the entire second floor and the garage. The days and hours of the operation are Monday – Friday from 8:00 am – 5:00 am. The Licensee has valid childcare liability insurance on file. LPA and the Licensee inspected the childcare areas for any potential dangers to health and safety hazards. LPA observed the childcare areas were in good condition and clean. The activities provided were age-appropriate and included imaginative, creative, and manipulative play. Moreover, the heating, lighting, and ventilation were sufficient, and no potential hazards could endanger children in care. The Licensee had a fully charged fire extinguisher that met the minimum standards of 2A 10 BC and a combination of carbon monoxide and smoke detector. A functional phone was also available in case of emergencies. Cleaning agents and detergents were safely stored out of children's reach, and the Licensee confirmed that no firearms or weapons were present on the premises. Continued on page 2...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

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: 01/24/2024

NARRATIVE

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LPA did not observe baby walkers, bouncers, or similar equipment in the childcare areas, and the Licensee was reminded that smoking is prohibited in the family childcare home. The backyard was fenced entirely with age-appropriate playthings and was free from any hazards or debris that could potentially pose a risk to the children in care. A soft cushion is underneath the play structure to prevent accidental falls.

During the inspection, LPA observed the crib and found it free of toys, blankets, or pillows. The mattress used in the crib was specifically designed to fit the crib's dimensions, and a bed sheet was securely fitted. Additionally, the licensee has taken the necessary steps to ensure the safety of infants in their care by implementing a check every 15 minutes, which was also documented and provided to LPA for review.

The licensee and helper have maintained complete records and have met all the necessary licensing requirements, including completing required immunizations, mandated reporter training, and maintaining a valid Pediatric CPR/First Aid certification. All the required posting documentation, such as the facility license, Notification of Parental Rights, and Earthquake Preparedness Checklist, have been placed in a prominent area for parents or representatives to review. According to the licensee, regular fire and earthquake drills are conducted at least once every six months. The latest drills were completed on 12/10/2023.

The records of all children who were present were reviewed. The licensee maintains accurate records for each child, including vaccination records, parental rights forms, and complete emergency information. These emergency documents contain information such as the child's full name, phone number, and the location of a parent or authorized person who may be contacted in an emergency. The records also contain the name and phone number of the child's doctor and the parent's permission for the licensee to consent to emergency medical care if needed.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

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: 01/24/2024

NARRATIVE

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During the inspection, LPA reviewed Forms/Records to Keep in Your Family Child Care Homes, children's forms/records, and personnel forms/documents with the Licensee. In addition, license capacity and limitations were also 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.

LPA discussed the safe sleep regulations with the Licensees and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.

Incidental 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: www.ada.gov/childqanda.htm.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

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: 01/24/2024

NARRATIVE

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The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

During the exit interview, the LICENSEE, JIN ZHU LI, confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and the report was reviewed with the licensee, Jin Zhu Li.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

LIC809 (FAS) - (06/04)

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