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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002679
Report Date: 09/10/2024
Date Signed: 10/14/2024 02:23:25 PM

Document Has Been Signed on 10/14/2024 02:23 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:MAI, WENDY C. & LEE, JACK C.FACILITY NUMBER:
414002679
ADMINISTRATOR/
DIRECTOR:		MAI, WENDY C.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 577-8880
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
09/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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On September 10, 2024, at approximately 1:35 pm, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced annual inspection and met with licensees Wendy Mai and Jack Lee, and purpose of inspection was explained. Present during today’s visit was both Licensees and 8 children (4 infants and 4 preschool age children). Facility is operating within capacity and ratio requirements on this day. All adults present in home have criminal background clearances. Childcare hours of operation are Monday - Friday from 8:30am to 5:30PM.

LPA and licensees toured the indoors and outdoors of the home for health and safety hazards. Home is a two-level home. Day Care Area: Entrance foyer for entering main daycare area, living room, dining room and backyard. Currently downstairs bedroom (baby room) is not being used, due to construction work. LPA observed a new wall separating living room and entrance foyer. Per licensees, wall is temporary due to construction noise and for separation. Off Limits Areas: The entire 2nd floor, kitchen, and garage. Isolation area for sick children is an area outdoors in dining room and away from other children. LPA reminded licensees to maintain child proof gate on staircase during construction. LPA observed home to be clean and orderly. Day-care is well light and has proper ventilation. LPA observed electrical outlets are secured with child proof covers and inaccessible to children. There are plenty of age-appropriate toys, books, and foam floor matting on floors. Backyard patio area is equipped with foam mat flooring to cushion falls. Per licensees, back yard is for running and playing. Patio is equipped with an awning to keep children cool during hot days. LPA did not observe any spas, pools, or other bodies of water. Entire outdoor patio is surrounded with a 5 ft. fence.

Home is equipped with a working dual carbon monoxide/smoke detector. LPA observed a fully charged fire extinguisher located on entrance of kitchen wall. LPA reviewed first aid kit and kit is fully stocked. Licensee maintains a landline and uses a cell phone on the premise. Per licensees, there are no weapons or firearms in the home. Licensee provides sheets for children in care and washes them on a weekly basis or as needed.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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 3
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: MAI, WENDY C. & LEE, JACK C.
FACILITY NUMBER: 414002679
VISIT DATE: 09/10/2024
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LPA reviewed 6 children’s files and 2 staff files. All files were complete with all required documents, including sleep logs. Licensees maintains an updated Children’s roster. Both Licensees CPR/FA expiration date is 9/2026. Licensee Mandated Reporter training expires 09/2026 for both licensees. Licensees provide meals to children in care, which includes breakfast, lunch and snacks. LPA reminded licensee any food brought from home must be labeled and stored properly. LPA observed Childcare License, Emergency Disaster Plan (LIC610A) and Parent's rights posted. Last emergency drill was conducted on 09/03/2024 and is properly documented. Licensee liability insurance is included via AAA effective 08/14/2024.

Licensees 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.

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/.

The Licensees was reminded about the Provider Information Notices (PINs) on the CCLD website. 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's reviewed AB 1207 with the Licensee.

Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MAI, WENDY C. & LEE, JACK C.
FACILITY NUMBER: 414002679
VISIT DATE: 09/10/2024
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As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com

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-and-resources/safe-sleep as an additional resource. LPAs also informed licensees 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.

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

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

During the exit interview, the LICENSEES, Wendy Mai, and Jack Lee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.



No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.

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

Exit interview conducted and report was reviewed with the licensees, Wendy Mai and Jack Lee.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC809 (FAS) - (06/04)
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