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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004735
Report Date: 11/07/2023
Date Signed: 11/07/2023 11:20:13 AM

Document Has Been Signed on 11/07/2023 11:20 AM - 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:YANG, YUFACILITY NUMBER:
414004735
ADMINISTRATOR:YANG, YUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 922-8838
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
11/07/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Yu YangTIME COMPLETED:
11:30 AM
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On 11/7/2023 at 10:30AM., Licensing Program Analysts (LPAs), Luis J. Gomez and Man Tso, met with Licensee, Yu Yang. Purpose of inspection was explained and was for an Unannounced, Case Management inspection, to add Bedroom #1, #3 and backyard to the on-limit areas. Present was the licensee caring for 3 children. ( 2 infant-age, 1 preschool age). Adults have criminal record clearances on file. Licensee’s home is a 4 bedroom, 2 bathroom, 1 level house. Days and hours of operations are: Monday- Friday, 8:00AM.- 5:00PM. Daycare Areas are: Living Room (Playroom); and Bathroom #1. Off-limit Areas are: Bedrooms #2, #3, #4, Garage, Kitchen, and Outdoor Backyard Area. LPAs inspected facility with licensee for health and safety hazards. LPA inspected home with licensee for health and safety hazards.

LPAs inspected bedroom #1 and bedroom #3 for health and safety hazards. Bedrooms were clean, with several play pens available. LPAs observed play pens were equipped with properly sized mattress and tight-fitting sheet. LPAs reminded licensee to ensure no loose object are stored inside napping area. Bedroom closets were reviewed during inspection. All accessible outlets have been covered. Per licensee, bedrooms will be used for napping services only.

LPAs inspected the outdoor, backyard area. Playthings inspected were in good repair. Back yard area does not have any pools, jacuzzi, fishponds or bodies of water.

Updated Facility Sketch (LIC999) have been submitted to the department.

On 11/7/2023, Bedrooms #1 and Bedroom #3 were added to the on-limit areas.

**No deficiencies were cited against the facility today under CCR, Title 22, Div. 12, Chapter. 3**



Report was reviewed and copy was issued to Licensee, Yu Yang. This report will be kept in the facility file and made available for public review upon request.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2023
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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