384004742-6-14-2023-05-CC-JYEE-CSSND6-20230614102149

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004742
Report Date: 06/14/2023
Date Signed: 06/14/2023 10:22:13 AM

Document Has Been Signed on 06/14/2023 10:22 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:	WU, CHUN QIAO		FACILITY NUMBER:	384004742
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	06/14/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Chun Qiao Wu		TIME COMPLETED:	10:45 AM

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	Licensing Program Analyst, LPA Yee conducted a pre-licensing inspection today. LPA, and the applicant, Chun Qiao Wu, toured the entire house for health and safety hazards. Current residents are Chun Qiao, and her 13 yr old son, 12 yr old daughter, 9 yr old son. Days and hours of operation: Monday to Friday between 8:00 AM to 6:00 PM. This is a change of location and increase in capacity. The fire clearance was approved on 05/24/2023. Day Care Areas (lower level): living room, and half bathroom. The backyard is not licensed today. If use it needs to be inspected. Off-limit areas: garage, the entire upper level. The applicant, Chun Qiao owns this home. The control of the property is on file. The home is equipped with a carbon monoxide detector, a smoke detector and a fire extinguisher. LPA advised them to conduct emergency drills once every six months and keep a log sheet. CPR and 1st aid are current until 10/02/2023. The facility does not have a body of water such as a swimming pool, or hot tub. No pets. Discipline policy was discussed. The facility will provide morning snacks, afternoon snacks, and lunches. The gate is used to prevent children from going to the off limit areas. LPA review AB 1207 with the applicant. As of January 1, 2018, all staff members are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Applicant completed AB 1207 on 04-15-23. A certificate is on file. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, an 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

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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: WU, CHUN QIAO	FACILITY NUMBER: 384004742
	VISIT DATE: 06/14/2023

NARRATIVE

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The licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, before initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/person will be assessed if this regulation is violated. Applicant's husband is not living at home at the moment. When return, he needs to be fingerprint cleared. The applicant said she understands.

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

Individual Infant Sleeping Plan (LIC9227) form was discussed and provided. When the infant is napping, it needs to be checked every 15 mins and documented on a log sheet. A sample log sheet was explained and provided. Technical support for COVID was discussed. Website for forms and regulations: www.ccld.ca.gov.

A capacity worksheet was explained and provided.

LPA will recommend a large FCCH license effective today, 06-14-2023.

Office: 650-266-8800, Monday-Friday
cclsanbrunocc@dss.ca.gov

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

LIC809 (FAS) - (06/04)

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