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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004833
Report Date: 02/14/2025
Date Signed: 02/14/2025 12:08:59 PM

Document Has Been Signed on 02/14/2025 12:08 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/
DIRECTOR:		CHAN, JENNY S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 936-4128
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
02/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:31 AM
MET WITH:Jenny ChanTIME VISIT/
INSPECTION COMPLETED:
12:25 PM
NARRATIVE
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On February 14, 2025, the Licensing Program Analyst (LPA) Van conducted an annual inspection and met with the Licensee, Jenny Chan. LPA explained the inspection's purpose to the Licensee over the telecom and was asked to wait. Approximately five minutes later, Licensee opened the door and granted access to the residence.

Upon entering the home, LPA observed six children playing in the living room with the licensee and one of the assistants, while five other children were in the infant room with another assistant. In total, there were 12 children present during the inspection. One of the children was the licensee’s three-year-old minor, who the licensee’s father picked up during the visit to be taken to school. The licensee complied with the licensing capacity and limitations today.

All staff members present at the time of the inspection had their criminal record clearances checked with the CDSS Background Check System and were found to have eligible clearance statuses on file.

According to the Licensee, there were no changes to the previously approved childcare areas. Childcare areas: 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.

LPA and the Licensee inspected the childcare spaces to identify potential health and safety concerns. There was no fireplace in the home. The licensee offers age-appropriate books and activities for children learning and play. The home has sufficient heating, lighting, and ventilation, with no noted risks that could harm the children. The LPA advised the licensee to ensure that she and her assistants promptly cover the stove knobs after use, especially since the stove is located in the child care living area. It was noted that one of the knobs had been left uncovered during the visit.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2025
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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Document Has Been Signed on 02/14/2025 12:08 PM - It Cannot Be Edited


Created By: Brendon Van On 02/14/2025 at 11:06 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHAN, JENNY S.
FACILITY NUMBER: 384004833

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, hygiene products like lotions, hairspray, and dental supplies were kept under the bathroom cabinet, which lacked child-proof locks or latches. This made the items accessible to children. Failure to lock up cleaning or hygiene products and make them accessible to children could pose(s) a potential health and safety risk to children in care.
POC Due Date: 02/28/2025
Plan of Correction
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The licensee plans to purchase and install child-proof locks or latches for the cabinet doors. Additionally, the Licensee will remind her assistants to ensure all cleaning products are inaccessible to children. A return inspection is required to ensure the cabinet has locks/latches installed.
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, it was found that the licensee did not consistently document the 15-minute increment checks for infant sleeping logs. This lack of consistent documentation poses a potential risk to the health, safety, or personal rights of infants in care.
POC Due Date: 02/28/2025
Plan of Correction
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The Licensee must consistently document the 15-minute checks for all infants during nap time. These records must be available for review upon request. A follow-up visit is required to verify that the Licensee has implemented the change. The plan of correction is due on 2/28/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Garfield Leung
LICENSING EVALUATOR NAME:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2025


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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: 02/14/2025
NARRATIVE
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The home has a combination carbon monoxide and smoke detector and a fully charged fire extinguisher, with multiple fire extinguishers with a minimum specification of 2A 10 BC. The licensee affirmed that the home does not contain any firearms or weapons. LPA observed no baby walkers, bouncers, or comparable items in the childcare areas. The licensee was reminded that smoking is prohibited in the family childcare home.

The bedroom/nap room was found to be cluttered with open and unopened boxes stacked and scattered next to the two cribs, creating tripping hazards for both staff and children. The licensee mentioned that she had been using the nap room for storage. During the inspection, the licensee initially requested that the nap room be designated as off-limits and mentioned plans to relocate the two infant cribs to a different room intended for infants. However, the licensee changed her mind and restored the nap room to its original condition from the pre-licensing phase, choosing to continue using it as a designated childcare area. She must purchase a child-proof lock for the sliding door in the nap room.

It was noted that hygiene products like lotions, hairspray, and dental supplies were kept under the bathroom cabinet, which lacked child-proof locks or latches. This made the items accessible to children. The licensee immediately gathered and cleaned all these products, relocating them to an off-limited secure area. The licensee plans to install child-proof locks or latches on the cabinet as a long-term solution. A technical violation was issued as a result.

LPA observed two infant cribs. Each crib was found to be free of blankets or pillows. The mattresses fit the dimensions of the cribs. However, one of the two cribs was observed with a loose bedsheet that could easily come undone. The 15-minute sleep logs for the infants were reviewed, and it was found that the licensee did not consistently document the safe sleep log for infants every 15 minutes. Three of the four infants did not have complete sleep logs, whereas the logs were recorded for only a few days.

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

DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025
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: 02/14/2025
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During the visit, LPA reviewed the records for both children and personnel. The licensee keeps accurate records for each child, including vaccination records, parental rights forms, and complete emergency information. The licensee and assistants have maintained records of all essential licensing requirements, such as necessary immunizations. All staff members have valid Pediatric First Aid CPR certifications and mandated reporter training.

All the required licensing postings were observed posted. According to the licensee, regular fire and earthquake drills are conducted quarterly, with the most recent drills completed on 11/4/2024.

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.

Incidental 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: www.ada.gov/childqanda.htm.

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

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

DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025
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: 02/14/2025
NARRATIVE
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Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

See LIC 809D for deficiencies cited during today’s inspection.

During the exit interview, the LICENSEE, JENNY CHAN, confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and the report and appeal rights were reviewed with the licensee, Jenny Chan.

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

DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025
LIC809 (FAS) - (06/04)
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