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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004833
Report Date: 02/07/2024
Date Signed: 02/07/2024 05:52:10 PM

Document Has Been Signed on 02/07/2024 05:52 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:CHAN, JENNY S.FACILITY NUMBER:
384004833
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
02/07/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Jenny ChanTIME COMPLETED:
06:00 PM
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On February 7, 2024, Licensing Program Analyst (LPA) Van met with the Licensee, Jenny Chan, for a Pre-Licensing relocation inspection and a capacity increase. The Licensee relocate from facility #384004604. The purpose of the inspection was explained, and LPA granted entry to the home by the Licensee. The licensee has no children today. Operation hours are Monday – Friday from 8:00 am – 8:00 pm and Saturday – Sunday from 8:00 am – 4:30 pm, and the age group provided will be 6 months to 8 years old. All staff and adult residents have fingerprint clearance, which has already been transferred to this new facility.

The Licensee and LPA inspected the inside and outside of the home for health and safety Hazards. The Licensee rents this apartment unit, which consists of three bedrooms and three bathrooms. The Licensee is the only resident of the home. Childcare areas will be the living room, kitchen, bedroom/playroom, bedroom/nap room, and bathroom #1. Off-limit areas are the licensee’s bedroom, bathrooms #2 and #3, and the patio on the back. The home has age-appropriate toys and equipment available for children in care. The home has multiple combination carbon monoxide detectors and fully charged 2A 10 BC fire extinguishers. The Licensee plans to use the mobile phone to use during operation hours. The First Aid Kit is fully stocked and accessible. There are no pools, spas, or bodies of water on the property. All cleaning supplies, poisons, and other chemicals are stored in the off-limit closet. All harmful and sharp objects are made inaccessible to children in care. All kitchen cabinets and drawers were observed locked with child-proof latches. The Licensee stated there are no guns or weapons in the home.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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: CHAN, JENNY S.
FACILITY NUMBER: 384004833
VISIT DATE: 02/07/2024
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LPA reminded the Licensee to conduct an emergency drill once every six months, and log drills are required. The posting area will be on the right-side wall by the main entrance. The Licensee is reminded that NO walkers, jumpers, bouncers, or any similar items are to be used for children in care and shall be made inaccessible. In addition, smoking is prohibited at the daycare.

During the inspection, the following was discussed and reviewed with the Licensee:
· Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
· Incidentals Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm
· The Licensee was reminded of the Department Inspection Authority. An employee or agent of the Department shall, upon presentation of proper identification, enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice,
· The Licensee was reminded that as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.622.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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: CHAN, JENNY S.
FACILITY NUMBER: 384004833
VISIT DATE: 02/07/2024
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·The Licensee was reminded about Mandated Reporter training available on the CCLD website. Training must be completed every two years by all staff hired. Training can be taken online at www.mandatedreporterca.com. If training is unavailable in the native language, a statement can be written stating exemption until the translation is available.
· Mandatory Posting Requirements: License, Emergency Disaster Plan, and Notification of Parents’ Rights Poster.
· The capacity limit of a Large License was discussed with Licensee. The Licensee was reminded that a Helper must be present when operating at a large capacity. In addition, Pediatric FirstAid CPR is required for all helpers.
· LPA discussed the safe sleep regulations with the licensee 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 [applicant, 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.

The licensee has submitted the proof of control of the property to the Licensing Department.

Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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: CHAN, JENNY S.
FACILITY NUMBER: 384004833
VISIT DATE: 02/07/2024
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On this date, 2/7/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Prior to licensure, the following issues need to be addressed.
· Install a childproof lock on the refrigerator door located in the kitchen.
· Fire clearance from the SF fire department.

An exit interview was conducted, and the report was reviewed with the licensee, Jenny Chan.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC809 (FAS) - (06/04)
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