414004541-6-21-2024-05-CC-MZAA-D6FQB7-20240621120100

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004541
Report Date: 06/21/2024
Date Signed: 06/21/2024 12:01:06 PM

Document Has Been Signed on 06/21/2024 12:01 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:	WU, LEILEI		FACILITY NUMBER:	414004541
ADMINISTRATOR/ DIRECTOR:	WU, LEILEI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 417-5342
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY: 14; 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 12	DATE:	06/21/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Staff memeber, Lishao Mai		TIME VISIT/ INSPECTION COMPLETED:	12:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On June 6, 2024 at approximately 9:30am, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA was greeted and granted access by licensee’s staff member, Lishao Mai. Per staff member, licensee was in an appointment and will arrive later. At the entrance staff member was explained the purpose of the inspection. Present during LPA's visit included 2 staff members, and 12 children (2 infants and 10 preschool age). Hours of operation are Monday through Friday. 8:00am to 6:00pm. Licensee lives in a one-level home. All adults living in the home and staff present, have fingerprint clearance on file. The DAY CARE AREAS are Bedroom #1 (napping room), bathroom #1, dining room, Living room, and backyard. The OFF LIMIT AREAS are kitchen, bedroom #2, bedroom #3, garage, bathroom #2. Off limit areas are made inaccessible with child safety gates. LPA toured day care areas of home with staff member. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good condition. LPA observed electrical outlets to be made inaccessible with child safety covers. Cleaning supplies, poisons and hazardous materials are stored in home's high shelves and/or locked behind child safety locked cabinets. Home is equipped with a fully charged fire extinguisher and dual smoke and carbon monoxide detector. Smoke and carbon monoxide detectors were tested during visit and was observed to be in working condition. There are no pools, and bodies of water in the premises. Napping room (bedroom#1) was observed to be equipped with cribs for napping children and cots. Cribs were observed to be free of loose articles, bumper pads and pillows. LPA observed cots to have tight fitting sheets. Sleeping logs for napping infants are maintained and includes the 15-minute time check of when infant was last checked on. Per staff member, parents provide sheets and are taken home weekly for wash. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WU, LEILEI	FACILITY NUMBER: 414004541
	VISIT DATE: 06/21/2024

NARRATIVE

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Bathroom was observed to be in proper working condition. There is appropriate sanitation and toileting equipment for children in care. LPA observed children’s diapers and wipes to be properly labeled with each child’s individual names in cubbies. Per staff member, children’s families provide diapers and wipes for enrolled children.

Children eat in dining area. A food service is provided to children that includes breakfast, lunch and 2 snacks. Per staff member children are welcome to bring lunch from home. Lunch that is brought from home is stored in fridge labeled with child’s name in lunchbox. LPA observed eating area to be clean and equipped with appropriate dining furniture. LPA observed knives to be made inaccessible.

Outdoor area is entirely enclosed and fenced. Outdoor area includes a variety of toys and equipment that were in good condition. Outdoor area has wood flooring and has an outdoors umbrella for shade. LPA did not observe any pools, spas or bodies of water on site.

LPA reviewed 6 random children's records which were complete. LPA reviewed staff members and all other staff who were present records, which were complete. Staff member has a current CPR/First Aid certification and current Mandated Reporter certification. Staff member’s CPR/First Aid certification will expire on 04/12/2026 and Mandated Reporter certifications will expire 04/16/2026. Licensee’s Mandated Reporter Certificate will expire on 04/15/2026 and CPR/First Aid certificate will expire 03/09/2026.

Emergency disaster drills are conducted and are appropriately documented. Last disaster drill was conducted 04/17/24. LPA observed licensing documentation to be properly posted, made available for review. Facility maintains a childcare roster that was also made available for review. Per staff member, there are no weapons or firearms in the home.

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.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024

LIC809 (FAS) - (06/04)

Page: 2 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: WU, LEILEI	FACILITY NUMBER: 414004541
	VISIT DATE: 06/21/2024

NARRATIVE

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Licensee 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.

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

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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

During the exit interview, the staff member, Lishao Mai, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed a Megan’s Law search on 06/10/2024.

No deficiencies were issued during today's visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the staff member, Lishao Mai.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024

LIC809 (FAS) - (06/04)

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