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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004680
Report Date: 07/03/2025
Date Signed: 07/03/2025 03:47:57 PM

Document Has Been Signed on 07/03/2025 03:47 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ZHANG, AIAIFACILITY NUMBER:
384004680
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
07/03/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Aiai ZhangTIME VISIT/
INSPECTION COMPLETED:
04:05 PM
NARRATIVE
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On July 3, 2025 at approximately 1:00pm, Licensing Program Analysts (LPAs) Catrina Quimbo and Diana Alvarado, conducted an unannounced, case management visit to the home. LPAs met with licensee, Aiai Zhang, and explained the purpose of the visit.

Licensee submitted a capacity increase application June 9, 2025. A fire clearance was obtained June 26, 2025. In conjunction with case management visit, LPAs also conducted an annual inspection.

Present during LPA's visit included licensee, licensee's spouse, licensee's parents and 7 children (2 infants, 4 preschool age and 1 school age). Licensee is operating within capacity limits and ratio during LPAs' visit. Licensee is aware any minor child (under 10 years old) living in the home will count towards their total ratio and capacity.

Licensee lives in the multi-level home with their spouse, minor child and parents. Licensee's spouse and mom are also assisting licensee with the family child care home. All adults living in the home have fingerprint clearance on file.

Hours of operation are Monday through Friday 8:30am to 5:30pm. The home includes a ground level and second level. The family childcare home currently operates on the second level of the home. The current DAY CARE AREAS are the living room, dining room, hallway bathroom and backyard (not currently in use). The current OFF LIMIT AREAS are all bedrooms on the second level of the home, kitchen, and the entire ground level of the home (except backyard). Off limit areas are made inaccessible with child safety gates, child safety door handles, and/or locked doors.

When licensee is approved for a large license, the family child care home will operate on the ground level of the home only that will include kitchenette, living room, bedroom #1 (napping room), bathroom, and backyard. When the licensee is approved for a large license, the entire second level of the home will be off limits.

With licensee, LPAs inspected entire home for health and safety hazards.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/03/2025
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ZHANG, AIAI
FACILITY NUMBER: 384004680
VISIT DATE: 07/03/2025
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Licensee plans to move toys and materials from the second level of the home to the ground level of the home. LPAs observed home to be clean and organized. Electrical outlets in current day care areas are made inaccessible with child safety covers. Licensee will make electrical outlets on the ground floor inaccessible to children. Home is equipped with a variety of toys and furniture that is clean and in good condition. Flooring in current day care areas includes soft padding. LPAs observed corners and edges to be padded. Licensee plans to install additional soft padding to the ground level of the home.

LPAs did not observe any accessible cleaning solutions or poisons in day care areas. Food service is provided by licensee that includes morning snack, lunch and afternoon snack/dinner. Reusable dishes are utilized for children that are sanitized in home's dishwasher daily. Per licensee, there are children currently enrolled with allergies.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Bathroom for children's use, both on the second level of the home and ground level of the home, were observed to be in working condition and equipped with age appropriate toileting equipment. Children's families provide diapers and wipes. LPAs observed children's materials to be stored appropriately, labeled with children's names. There is a garbage bin with a tight fitting lid to dispose of dirty diapers.

Preschool children sleep on floor mats. Sheets and blankets are provided by children's families and are sent home weekly for laundering. Infants sleep in cribs. LPAs observed cribs to be free of loose articles, materials and objects. LPAs observed cribs to have crib mattresses with tight fitting sheets. Sleeping logs are maintained for napping infants. LPA reviewed sleeping logs from random months that included January 2024, March 2024, January 2025 and April 2025. LPA observed sleeping logs to document the 15 minute stamp of when the napping infant is checked on while sleeping, the infant's breathing patterns, signs of distress, and the licensee's initials.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ZHANG, AIAI
FACILITY NUMBER: 384004680
VISIT DATE: 07/03/2025
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Backyard is fully fenced and enclosed. Licensee is not currently using backyard. LPAs observed backyard to include toys and materials that are currently covered. Licensee plans to clean the outdoor area prior to its use.

Home is equipped with a fully charged fire extinguisher, multiple first aid kits and a smoke and carbon monoxide detector. LPA tested carbon monoxide detector during today's visit, which was observed to be working.

Licensing documentation is properly posted and made available for review. A childcare roster was also made available for LPA's review. Emergency disaster drills are conducted and are appropriately documented. Last disaster drill was conducted 4/30/2025. Per licensee, there are no weapons or firearms in the home.

LPA reviewed facility records that included all enrolled children's records, licensee's record and assistants records. Children's records are complete with immunization records and individual infant sleeping forms. Licensee and assistants present have their required immunizations and current Mandated Reporter certifications. Licensee's CPR and First Aid certification is also current and will expire 11/2025.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.

Capacity limits and ratios for a large family day care have been reviewed with licensee on this date. LPA reminded licensee that an assistant must be present when operating as a large license. LPA reminded licensee when an assistant is not present, licensee must operate as a small license.

LPA will approve for the large license when licensee has moved children's materials from second level of home to ground level of home.

During the exit interview, the licensee, Aiai Zhang, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were issued today during LPA's visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Aiai Zhang.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2025
LIC809 (FAS) - (06/04)
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