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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004680
Report Date: 03/02/2023
Date Signed: 03/02/2023 11:32:52 AM

Document Has Been Signed on 03/02/2023 11:32 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:ZHANG, AIAIFACILITY NUMBER:
384004680
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/02/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Aiai ZhangTIME COMPLETED:
12:00 PM
NARRATIVE
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 On March 2, 2023, Licensing Program Analyst (LPA) Van conducted an announced relocation pre-licensing inspection and met with the Licensee, Aiai Zhang. The Licensee has requested to relocate from # 384004452 to this location. At present, there are no children at the daycare. The Licensee owns the home, which consists of 2 bedrooms and one and a half baths. The home residents are the Licensee, her husband, and a minor child. All criminal record clearances are on file. Daycare areas are the living room, dining room, bedroom #1, bathroom on the second floor, and backyard. Off-limit areas are bedroom #2 on the second floor, the garage, and the entire ground floor. Per Licensee, the dining area will be the isolation area for sick/ill children.
LPA and the Licensee inspected the entire home for Health and Safety Hazards. The home is clean and orderly and has sufficient lighting and ventilation. The fire extinguisher is fully charged with a 3A 40 BC specification. The home has a combination of working carbon monoxide & smoke detectors installed. During the inspection, carbon monoxide and fire alarms were tested and worked. All harmful objects, sharp objects, and toxins are stored out of the reach of children and made inaccessible to children. LPA observed the entry point to the kitchen has a childproof gate installed. The bathroom to be used by the children is clean, and no cleaning products are stored there. The Licensee states no firearms, weapons, or pets are in the home. LPA observed that the home has age-appropriate toys and equipment available for the children. All furniture was observed to be clean and well-maintained.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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: ZHANG, AIAI
FACILITY NUMBER: 384004680
VISIT DATE: 03/02/2023
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LPA observed all children's tables and chairs have a round corner. All Electrical outlets have plastic covers. LPA observed sizeable heater vents, which the Licensee is planning to install screens to cover the vents. The Licensee states that the facility provides children breakfast, lunch, and dinner. LPA reminded the Licensee to conduct an emergency drill once every six months and document the drills. The Licensee was informed that NO baby walkers, exer-saucers, jumpers, bouncers, or similar items are to be used for children in care and shall be made inaccessible. The Licensee was also reminded that smoking is prohibited at the daycare. In addition, LPA informed the Licesnee that if/when Licensee's minor child is present during operation hours, her child will be counted as part of the license capacity.
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.
Posting Parent's Rights and the Emergency Disaster Plan was reviewed with the Licensee. Records to be maintained were consulted and reviewed with the Licensee. The Licensee was informed to obtain a copy of regulations and current licensing forms through the Department's website at www.ccld.ca.gov. LPA also reminded the Licensees of the Family Child Care Home License's responsibilities and Reporting requirements.
LPA discussed the safe sleep regulations with the Licensee 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 Licensees 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.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: ZHANG, AIAI
FACILITY NUMBER: 384004680
VISIT DATE: 03/02/2023
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 Incidental Medical Services (IMS) was discussed with Licensee. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 reminded that as of September 1, 2016, a person may not be employed or volunteer at a child care 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. The Licensee was informed about the Provider Information Notices (PINs) on the CCLD website and the sign-up process. The Licensee was also reminded of Mandated Reporter Online Training for Child Care Providers (AB 1207) and the additional General Training, and both are available on www.mandatedreporteca.com.
Prior to licensure, the following issue must be addressed.
· Install screens for the heater vents.
· Needs to clean debris and overgrown plants/grasses in the backyard.

The report was reviewed and signed by Licensee Aiai Zhang.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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