414004837-7-20-2023-05-CC-CQUO-CTWSXU-20230720141632

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004837
Report Date: 07/20/2023
Date Signed: 07/20/2023 02:16:37 PM

Document Has Been Signed on 07/20/2023 02:16 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:	WU, QINGQING		FACILITY NUMBER:	414004837
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	07/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	QingQing "Hayley" Wu		TIME COMPLETED:	03:00 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 July 20, 2023 at approximately 12:45pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, QingQing "Hayley" Wu, and explained the purpose of the inspection. Present during LPA's visit included licensee and 5 enrolled children (2 infants and 3 preschool age). Licensee is operating within capacity limits and ratio during LPA's visit. Licensee lives in the multi-level home with their spouse and minor child. Licensee and their spouse have fingerprint clearance on file. Hours of operation are Monday through Friday 8:00am to 5:30pm. Entrance to day care is through side gate located on right side of the home. The DAY CARE AREAS are located on the ground floor of the home only that incudes a living room (main day care area), sleeping area, and front portion of the backyard. The OFF LIMITS AREAS is the kitchenette located in the main day care area, back portion of the backyard, garage and the entire upper level of home. Off limit areas are properly barricaded with child safety gates. LPA toured day care areas of home with the licensee. LPA observed day care areas to be in good repair with proper temperature and ventilation. Main day care area is equipped with a variety of toys and materials that were in good condition. Flooring in main day care areas is appropriately carpeted and padded that was observed to be clean and in good working condition. Cleaning supplies, poisons and solutions are made inaccessible in off limit areas or located behind child safety locked cabinets. LPA observed electrical outlets to be made inaccessible with child safety covers. Home is equipped with a fully charged fire extinguisher and a working carbon monoxide detector. Crib in napping area was observed to be free of any loose materials or objects. Mats that are utilized for napping children were appropriately stored. Bathroom for children's use was observed to be clean, in proper working condition, equipped with appropriate sanitation materials. Cabinets in bathroom were observed to have child safety locks. Garbage bins were observed to have tight fitting lids. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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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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: WU, QINGQING	FACILITY NUMBER: 414004837
	VISIT DATE: 07/20/2023

NARRATIVE

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Entire outdoor area is fully fenced and enclosed with an at least 4 ft. high fence. Front portion of the backyard is a day care area while back portion of backyard is an off limit area. Off limit area of backyard was observed to have a fence that is made inaccessible to children. Day care area of backyard is equipped with appropriate outdoor toys and materials that were in good working condition. LPA did not observe any pools, spas or bodies of water on site.

LPA reviewed six children's files, which were complete. Children's files have identification and emergency information on file. Licensee's CPR/First Aid training is current and will expire 11/2024. Licensee's Mandated Reporter training is also current and will expire 07/2025. Licensee has proof of required immunizations that were made available for review.

Required licensing documentation was properly posted near entrance of main day care area. Licensee maintains a child care roster that was made available for review. Licensee conducted and documents emergency disaster drills. Last emergency disaster drill was conducted 01/24/2023. Per licensee, 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.

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.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WU, QINGQING	FACILITY NUMBER: 414004837
	VISIT DATE: 07/20/2023

NARRATIVE

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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-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.

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/.

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 licensee, QingQing Wu, 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.

Exit interview conducted and report was reviewed with the licensee, QingQing Wu.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

LIC809 (FAS) - (06/04)

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