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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004958
Report Date: 08/27/2024
Date Signed: 08/27/2024 11:18:49 AM

Document Has Been Signed on 08/27/2024 11:18 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:MA, ZHIFANGFACILITY NUMBER:
414004958
ADMINISTRATOR/
DIRECTOR:		MA, ZHIFANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 888-7301
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/27/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Licensee, Zhifang "Catherine" MaTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
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On August 27th, 2024 at 10am, Licensing Program Manager (LPM) Marie Rodriguez, Licensing Program Analysts (LPAs) Leslit Tapia-Mandujano, Winnie Ly, and Almond Tso met with licensee, Zhifang “Catherine” Ma for an informal office meeting.

The purpose of the informal meeting was to discuss the Tittle 22 Regulations in regard to licensee’s involvement with facilities: Zhou, Yimin (414004959) and Xu, Jun (414002549).

Licensee was advised and reminded of the following:
· Licensee must be present in the home 80% of operating hours, a day.
· Licensee is responsible and liable for anything that occurs in her facility only.
· Licensee cannot be the main contact for facilities 414004959 and/or 414002549.
· Licensee must maintain files of children in care for only her facility and is not responsible for maintaining files of other facilities in her home.
· If licensee stays active and there are no children in care, licensee must maintain up to date all required certificates.
· Licensee may assist the other licensed facilities only if her license is on inactive status.

Licensee stated they are aware of the importance to be in compliance with all licensing regulations. Department will conduct additional visits to licensee's home to verify licensee's compliance with regulations.

During meeting the following resources were provided: Operation of a Family Child Care Home Regulations, Forms and Records to maintain in the home (LIC 311D), LIC 9211, Request for Inactive Child Care License Status, and PIN 22-02-CCP, Incidental Medical Services.

Exit interview was conducted and report was reviewed with licensee, Zhifang “Catherine” Ma.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2024
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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