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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600823
Report Date: 02/27/2025
Date Signed: 02/27/2025 12:53:51 PM

Document Has Been Signed on 02/27/2025 12:53 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 RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:EMERALD RESIDENTIAL CARE HOMEFACILITY NUMBER:
415600823
ADMINISTRATOR/
DIRECTOR:		GIL, ISABELLE B.FACILITY TYPE:
740
ADDRESS:1749 NEWBRIDGE AVENUETELEPHONE:
(650) 348-3054
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
02/27/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Isabelle GilTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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LPA Jeung reviewed corrections of deficiencies cited on 2/25/25 during annual inspection.
Acknowledgement of corrections made on 2/26/25 are given to Ms. Gil--2 pages.

The following Type A deficiencies still exist, as corrections were not made by 2/26/25:

Section 87303(e)(2) Maintenance and Operation
- Hot water temperature tested at 102 degrees
-- Civil penalty of $100 is assessed today for failure to correct deficiency by 2/26/25
--- Civil penalty of $100/day to be assessed until deficiency is corrected and CCLD is notified

Section 87468.1(a)(1) Personal Rights
- Video baby monitors are still in use upon LPA's arrival today
- Video cameras and baby monitors are removed in LPA's presence
-- Civil penalty of $100 is assessed today for failure to correct deficiency by 2/26/25


April CowanTELEPHONE: (650) 266-8889
Audrey JeungTELEPHONE: (650) 266-8891
DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2025
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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