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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004765
Report Date: 10/26/2023
Date Signed: 10/26/2023 02:05:03 PM

Document Has Been Signed on 10/26/2023 02:05 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:LI, MIN YIFACILITY NUMBER:
384004765
ADMINISTRATOR:LI, MIN YIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 794-2513
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 0DATE:
10/26/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Min Yi LiTIME COMPLETED:
02:15 PM
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Licensing Program Analyst, LPA Yee conducted a case management visit today. There are no children in care today. Three children are on vacation. One is out on dr appointment. Today, LPA inspected the backyard and approved.

Day Care Areas (lower level): living room, bedroom #3, bathroom, and backyard. The licensee will install a gate on the stairs that leading to daycare room and will send picture.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2023
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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