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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004123
Report Date: 10/22/2024
Date Signed: 10/22/2024 04:15:07 PM

Document Has Been Signed on 10/22/2024 04:15 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:ZHANG, MIAO HONGFACILITY NUMBER:
414004123
ADMINISTRATOR/
DIRECTOR:		ZHANG, MIAO HONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 837-8328
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
10/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Licensee, Miao Hong ZhangTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
NARRATIVE
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On 10/22/2024, at approximately 3:00 PM, Licensing Program Analysts (LPAs) Alvarado and Tse conducted an unannounced Plan of Correction (POC) Visit at the facility. LPAs met with the Licensee Miao Hong Zhang and explained the purpose of the visit. Present during the visit was Licensee, two helpers, three infants and eight preschoolers. The facility is in compliance with staffing and ratio requirements on this day.

On 9/10/2024, LPAs observed that two infants were napping with sleep sacks. Infant sleeping logs were also not maintained. LPAs informed Licensee that deficiencies would be cited during the visit. A plan of correction was discussed. A due date of 9/30/2024 was discussed and agreed upon by Licensee. A technical violation was also issued for keeping the door to the infant napping room closed.

During today’s visit, LPAs observed that the facility did not have any sleep sacks present. Licensee stated that she no longer uses them. Licensee also submitted infant sleeping logs to LPAs on 9/30/2024 by email. LPAs also observed that the door to the infant napping room remained open. LPAs discussed safe sleep regulations with Licensee during the visit.

Deficiencies cited on 9/10/2024 shall be cleared as of today’s date, 10/22/2024. A letter of deficiencies cleared was provided to Licensee.

No deficiencies were cited during today’s visit on 10/22/2024. A notice of site visit was provided and must be posted for 30 days. Exit interview conducted and reviewed with Licensee, Miao Hong Zhang.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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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