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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004546
Report Date: 08/28/2023
Date Signed: 08/28/2023 11:51:44 AM

Document Has Been Signed on 08/28/2023 11:51 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:LIU, JINGFACILITY NUMBER:
384004546
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
08/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Jing LiuTIME COMPLETED:
12:00 PM
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On August 28, 2023., Licensing Program Analyst (LPA) Van met with Licensee Jing Liu and her helper for an unannounced case management inspection capacity increase. The Licensee requested to increase from 8 to 14. The licensee’s helper provided a Mandarin translation. The purpose of the inspection was to process a capacity increase requested by the Licensee. Four children were supervised by the Licensee and helper today. The hours of operation are Monday through Friday, 8:30 am – 5:30 pm.

LPA inspected the facility for Health and Safety Hazards. Daycare Areas are on the first floor, consisting of a living room, bathroom, and front yard. During the inspection, the Licensee requested to remove the bedroom and study room/reception room from the daycare area. The new off-limit areas are the kitchen, storage room, bedroom, study room/reception room, and garage on the first floor and the entire upper level. All off-limit areas are appropriately barricaded. 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. The facility has age-appropriate furniture. The furniture is steady 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 the children are clean and toxic-free. During the inspection, LPA observed one of the baby cribs with toys attached to the side of the crib. A technical violation was issued.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2023
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: LIU, JING
FACILITY NUMBER: 384004546
VISIT DATE: 08/28/2023
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LPA reviewed and discussed the new Safe Sleep Regulation with the Licensee and her helper that there should be no toys or pillows inside the baby cribs/playpens and no objects hanging above them. LPA also discussed that all mattresses/padding should be designed for the particular cribs/playpens, and bedsheets should be tight-fitted. In addition, the helper was informed to physically check on the infant every 15 minutes during naptime and document them. The helper understood that no baby walkers, bouncers, exersaucers, or other similar items are permissible to be used during daycare hours.

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. See Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417 for IMS information. 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.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
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: LIU, JING
FACILITY NUMBER: 384004546
VISIT DATE: 08/28/2023
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·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.
· LPA reviewed with the Applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children's forms/records, facility forms/records, and all required postings.
· 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.
· 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 First Aid CPR is required for all helpers.

A large family child care home capacity increase will be recommended once the San Francisco Fire Department grants the Fire clearance STD 850. In addition, a new facility sketch must be submitted to LPA to reflect the change to the daycare or off-limit areas.

During the exit interview, the Licensee, Jing Liu, confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

Today's report and site visit notice was 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: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
LIC809 (FAS) - (06/04)
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