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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004607
Report Date: 02/27/2025
Date Signed: 02/27/2025 11:24:07 AM

Document Has Been Signed on 02/27/2025 11:24 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 CC RO, 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: 12CENSUS: 12DATE:
02/27/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:08 AM
MET WITH:Helen ChenTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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On February 27, 2025 at approximately 10:30 AM, Licensing Program Analysts (LPAs) Tso and Yee conducted an unannounced Case Management inspection. Purpose of the inspection was the follow up of the Informal Meeting at San Bruno Regional Office dated January 24, 2025. LPAs met with the Licensee, Helen Chen and explained the purpose of the inspection. Present in the facility is Licensee, 2 staff caring for a total of 12 children.

During today visit, the Licensee opened the door for LPAs and let LPAs to enter the facility. The Licensee and LPAs also inspected the 3rd floor (off-limits area) of the facility.

There were no deficiencies cited at this time under CCR, Title 22, Div. 12, Chapter 3. A copy of today’s report was given to the licensee.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Helen Chen.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2025
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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