<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004607
Report Date: 01/07/2025
Date Signed: 01/07/2025 12:26:11 PM

Document Has Been Signed on 01/07/2025 12:26 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:CHEN, HELEN Y.FACILITY NUMBER:
384004607
ADMINISTRATOR/
DIRECTOR:		CHEN, HELEN Y.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 385-9552
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
01/07/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:12 AM
MET WITH:Helen Y. ChenTIME VISIT/
INSPECTION COMPLETED:
12:35 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
Licensing Program Analysts, LPAs, Yee, and Tso conducted a follow-up visit in regards to the citations cited on 12/19/2024. Upon arrival, the licensee, Helen Chen was not present. Helper, YanYi opened the door. The purpose of the visit was explained. There were two helpers and 11 children present today. The licensee, Helen arrived 15 minutes later. Children's records were reviewed. Children's records are still incomplete. A civil penalty of $250 was issued today. The facility personnel summary report was reviewed with Helen. She stated that it is current. Notice site visit and lic809, lic809d cited on 12-19-2024 were not posted. A civil penalty of $100 was issued today.

The office meeting is scheduled for January 24, 2025. A letter of invitation was hand-delivered today to Ms. Chen.

This report and appeal rights were provided and reviewed with the licensee. Notice of Site Visit shall remain posted for 30 days.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 01/07/2025 12:26 PM - It Cannot Be Edited


Created By: Jennifer Yee On 01/03/2025 at 12:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHEN, HELEN Y.
FACILITY NUMBER: 384004607

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/07/2025
Section Cited
HSC
1596.817(b)(1)

1
2
3
4
5
6
7
HSC 1596.817(b)(1): The notice posted pursuant to subdivision (a) shall remain posted for 30 consecutive days. LPA reminded the licensee via email on 12-23-2024 via email.
1
2
3
4
5
6
7
Office meeting is scheduled for January-24-2025.
8
9
10
11
12
13
14
This requirement has not been met as evidenced by:

LPA observed LIC 809, LIC 809-D, and Notice of Site Visit were not posted on the wall which poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
An immediate civil penalty of $100 has been assessed.
Type B
01/07/2025
Section Cited
HSC1596.8595(c)(1)

1
2
3
4
5
6
7
HSC 1596.8595(c)(1): A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b. LPA reminded the licensee via email on 12-23-2024.
1
2
3
4
5
6
7
Office meeting is scheduled for January 24-2025
8
9
10
11
12
13
14
This requirement has not been met as evidenced by:

Licensee was unable to provide LIC 809, LIC 809-D , and LIC 9224 Acknowledgement of Receipt of Licensing Reports to LPA. Per licensee, not all parents received and signed the LIC 9224 as required for a type A violation which is a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ali Zebila
LICENSING EVALUATOR NAME:Jennifer Yee
LICENSING EVALUATOR SIGNATURE:
DATE: 01/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/07/2025


LIC809 (FAS) - (06/04)
Page: 2 of 2