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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004683
Report Date: 02/13/2025
Date Signed: 02/13/2025 12:36:11 PM

Document Has Been Signed on 02/13/2025 12:36 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:WANG, SHAO HUAFACILITY NUMBER:
384004683
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 3DATE:
02/13/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:39 AM
MET WITH:Shao Hua WangTIME VISIT/
INSPECTION COMPLETED:
12:45 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
On February 13, 2025, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit. LPA met with the Licensee, Shao Hua Wang, and explained the purpose of the visit.

Today’s visit included three children (one infant and two pre-k) and the licensee. The licensee has a small license and operates within this visit's capacity limits and ratios.

Per the licensee, she has six enrolled children in her daycare. LPA reviewed the facility’s children's roster and found it completed.

LPA observed that all required documents, such as the facility license, the Notification of Parental Rights, and the Earthquake Preparedness Checklist, were displayed and visible to the public.

The most recent emergency disaster drill was conducted on January 24, 2025, and the LPA observed that it was documented. LPA reviewed the emergency disaster drill log and found they were conducted at least once every six months.

Daycare Areas: The upper level includes a living room, dining room, one-and-a-half bathroom, and backyard.

Off-limit Areas: The entire lower level, garage, two bedrooms on the upper level, and a kitchen on the upper level.

LPA inspected the indoor and outdoor daycare areas to identify health and safety hazards. The home had a fire extinguisher, a first aid kit, a carbon monoxide detector, and a smoke detector. LPA tested the carbon monoxide and smoke detector and found them both functioning.

LPA observed that the home's interior was clean and orderly. Disinfectants, cleaning solutions, poisons, and other hazardous items were stored in areas inaccessible to children. The bathroom was clean, fully operational, and equipped with suitable toileting equipment and sanitation products.

See Page 2

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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 5
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: WANG, SHAO HUA
FACILITY NUMBER: 384004683
VISIT DATE: 02/13/2025
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
26
27
28
29
30
31
32
Page 2

LPA observed that the daycare areas had age-appropriate toys, furniture, and educational materials. The fireplace was covered with a children’s play shelf. A designated area was provided for permanent or portable storage of the children's clothing and personal belongings. Electrical outlets were fitted with child safety covers to prevent children's access. A child safety gate was observed at the upper-level entrance of the stairs.

The licensee stated that no firearms or weapons were present on the property.

The backyard is surrounded by a fence and features a variety of outdoor play equipment, all of which are in excellent condition. LPA did not observe any pools, spas, or bodies of water on the property.

The licensee stated she provides the children with breakfast, lunch, and snacks. The licensee stated no documented allergies among any of the enrolled children.

The facility offers different options for children to rest or nap, including cribs and children’s sleeping beds. LPA observed that sheets and blankets were available for the children. Per the licensee, she provides the children with blankets and sheets, washing them weekly. Infant mattresses are firm and equipped with appropriately sized sheets. All cribs are well-maintained and free of loose items that could pose safety risks.

LPA reviewed the files of three children and confirmed that one is missing her updated immunization record. The facility was issued a technical violation for missing the above immunization requirement. The two other children’s records had the required documents in their files. LPA also reviewed the 15-minute sleep records for one child under two and confirmed they were documented.

LPA reviewed the licensee’s files and confirmed that the licensee holds a valid Pediatric First Aid/CPR certification, which is set to expire in April 2026. The licensee stated that she did not have her MMR and seasonal Influenza vaccination records available for review. The facility was issued a technical violation for missing the above immunization requirement.

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.

See Page 3

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: WANG, SHAO HUA
FACILITY NUMBER: 384004683
VISIT DATE: 02/13/2025
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
26
27
28
29
30
31
32
Page 3
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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/.

LPA discussed the safe sleep regulations with licensee 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 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.

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.

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

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.

TECHNICAL VIOLATION: Violations of the Health and Safety Code (HSC), regulations (CCR), or interim licensing standards (ILS) that do not pose a health, safety or personal rights risk.

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, Shao Hua Wang.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5