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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004683
Report Date: 04/11/2024
Date Signed: 04/11/2024 12:10:30 PM

Document Has Been Signed on 04/11/2024 12:10 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:WANG, SHAO HUAFACILITY NUMBER:
384004683
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
04/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Shao Hua Wang (Eva)TIME VISIT/
INSPECTION COMPLETED:
12:35 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Shao Hua Wang (Eva), her husband, and her minor child. LPA explained the purpose of the inspection to her. All adults have fingerprint clearance. The facility had 2 infatns and 2 preschoolers present during the inspection. The facility is also called ABC Family Day Care, and the operation hours are Monday to Friday from 8 AM to 5:30 PM. The licensee owns and lives with her husband and son in this 2 stories single-family house that has 2 bedrooms and 1 and a half bathrooms, a kitchen, a living room, and a dining room on the upper level; a garage and a backyard on the lower level. The daycare areas are a living room, a dining room, and a one-and-a-half bathroom, The off-limit areas are the entire lower level including a garage and a backyard, 2 bedrooms, and a kitchen on the upper level. LPA inspected the facility for health and safety hazards. The facility was clean, the temperature and lighting were adequate, and toxins and harmful objects were made inaccessible to the children. The licensee installed gates at the stairway, the entrance of the kitchen, and the entrance of the living room to prevent children from accessing the off-limit areas. The licensee installed soft cushioning on the daycare floor to prevent injury. The windows had window locks at the windows in the living room and dining room. There were cubbies available for the children to store their belongings by the stairway. A crib and playpen were available for napping. There were plenty of age-appropriate toys, books, ride-on toys, slides, fake kitchens, and children's furniture that were in good condition and repaired. There was a fully charged 2A10BC fire extinguisher, first suppliers, and working smoke and carbon monoxide detectors. The facility provides AM/PM snacks, lunch, and dinner to the children. The fireplace was blocked by a shelf. Boosters were available for feeding only. Childproof knobs were installed on the door of the kitchen and dining. Per the licensee, there were no children on special medication. LPA reviewed the children's files and obtained a copy of the children's roster. The licensee had current CPR/first aid training that will expire in 4/2024. The licensee will renew the CPR/First Aid training this month.
continues in LIC809C
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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 3
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: WANG, SHAO HUA
FACILITY NUMBER: 384004683
VISIT DATE: 04/11/2024
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Criminal Record Clearance - Licensee was reminded that all adults 18 and over living or working in 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.

Safe Sleep - LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, 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: https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
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: WANG, SHAO HUA
FACILITY NUMBER: 384004683
VISIT DATE: 04/11/2024
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MyChildCarePlan.org – 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.

Megan’s Law - During the exit interview, Shao Hua Wang (Eva) , confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the licensee, Shao Hua Wang (Eva).
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC809 (FAS) - (06/04)
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