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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005006
Report Date: 04/28/2023
Date Signed: 04/28/2023 10:26:12 AM

Document Has Been Signed on 04/28/2023 10:26 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:HUNG, HUI LINFACILITY NUMBER:
414005006
ADMINISTRATOR:HUNG, HUI LINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 208-1063
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/28/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Hui Lin HungTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Marie Rodriguez conducted a scheduled pre-licensing inspection and met with Licensee Hui Lin "Helen" Hung. Licensee has applied for change of location application. Current license is 414004801. Home is a single story house with three bedrooms and two bathrooms that the Licensee rents. Residing in the home is the Licensee and her sister. Hours of operation are Monday to Friday from 8:00am to 6:00pm.

LPA and Applicant inspected entire home for health and safety hazards. Daycare Areas: Living room, master bedroom, master bathroom, backyard, and dining room (only to pass through to go into backyard). Off Limit Areas: Kitchen, dining room, bedroom #2, bedroom #3, and bathroom #2. All off limit areas, including all closets, are properly barricaded. Home is clean and orderly with sufficient lighting and ventilation. Home has age appropriate toys and equipment available for children in care. Home has a working telephone and a fully charged fire extinguisher. Due to the sudden move of the Licensee, smoke and carbon monoxide detectors will be installed this weekend. Licensee will provide LPA with pictures once they've been installed. First aid kit is fully stocked and accessible. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children. Per Licensee, there are no firearms in the home. There are no bodies of water on the premises.

Licensee states she will conduct an emergency drill at least once every six months and will log drills. Licensee states discipline policy is redirection. Licensee's pediatric first aid/CPR certificate expires July 2023. Postings will be posted by the entrance to the home. Licensee was reminded of NO walkers, exersaucers, jumpers, bouncers, and any similar items to be used for children in care and shall be made inaccessible.

Capacity limits of a small and large license were discussed with the Licensee. Licensee was reminded that when operating at a large capacity, there must be a helper present.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2023
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: HUNG, HUI LIN
FACILITY NUMBER: 414005006
VISIT DATE: 04/28/2023
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Small Family Child Care License has been granted and is effective as of today, April 28, 2023.
Licensee has applied for a Large Family Child Care License but it won't be granted until fire clearance inspection has been conducted and granted by the fire inspector. Fire clearance inspection is scheduled for May 9, 2023.

Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every two years for Licensee and staff. Training can be completed online at www.mandatedreporterca.com.

Licensee was reminded, as of September 1, 2016, all staff and volunteers must provide proof of immunization against pertussis (dTap), measles (MMR), and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.662.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/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 at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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 purchaged 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: http://www.ada.gov/childqanda.htm.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023
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: HUNG, HUI LIN
FACILITY NUMBER: 414005006
VISIT DATE: 04/28/2023
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LPA reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the Licensee.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilties, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Licensee Hui Lin Hung.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023
LIC809 (FAS) - (06/04)
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