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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004546
Report Date: 11/08/2023
Date Signed: 11/08/2023 05:04:01 PM

Document Has Been Signed on 11/08/2023 05:04 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:LIU, JINGFACILITY NUMBER:
384004546
ADMINISTRATOR:LIU, JINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 349-1068
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94132
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
11/08/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Liu JingTIME COMPLETED:
05:15 PM
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On November 8, 2023., Licensing Program Analyst (LPA) Van met with the Licensee, Jing Liu, for an unannounced inspection of the Plan of Correction (POC). The purpose of the inspection was explained, and the Licensee granted LPA entry to the home. Five children were in care with the Licensee and a helper today (4 infants and one preschooler). The licensee’s helper provided a Mandarin translation.

During the annual inspection on October 25, 2023, a type A deficiency was found where LPA discovered that the licensee was supervising five children, four infants and one preschooler. The Licensee did not adhere to her licensed capacity limitations. Today's inspection was conducted to ensure that the Licensee was following her licensing requirements. Based on LPA’s observations, the Licensee was present with an assistant supervising five children, including four infants and one preschooler. The Licensee was found to be in compliance with her licensed capacity. The Licensee acknowledged that she must follow the small licensee's capacity and limitations if she did not have an assistant. It was noted that the Type A deficiency cited during the October 12, 2023, inspection has been cleared during today's inspection.

The other deficiency cited on October 25, 2023, was that the licensee did not have valid Pediatric First Aid CPR training. However, the licensee has already registered for a CPR class on November 11, 2023. After completing the training, the licensee can submit proof of the CPR certification to LPA via email by November 17, 2023. No return visit is necessary.

An exit interview was conducted with the Licensee, and a consultation was provided. In today's inspection, no deficiencies were observed. The Licensee, Jing Liu, read and signed the report. Today's report and notice of the site 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: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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