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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505659
Report Date: 06/16/2022
Date Signed: 06/16/2022 02:53:10 PM

Document Has Been Signed on 06/16/2022 02:53 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:QUACH, NGOC TRAN & TRUONG, HUE LINHFACILITY NUMBER:
380505659
ADMINISTRATOR:QUACH, NGOC TRANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 759-5181
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 3DATE:
06/16/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Truong, Hue LinhTIME COMPLETED:
03:15 PM
NARRATIVE
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On June 16, 2022, Licensing Program Analyst (LPA) Van met with the Licensee, Truong Hue Linh, for an unannounced inspection of the Plan of Correction (POC). The purpose of the inspection was explained, and was granted entry to the home of the Licensee. There are three preschool children in care with the Licensee today. All staff present have criminal record clearance on file.

On May 13, 2022, during the required annual inspection, the following deficiencies were cited:
· Health and Safety Code section 1596.8662(b)(1). Personnel records review confirmed that both Licensees did not have Mandated Reporter training completed. Today's inspection, Licensees provided the completed Mandated Reporter Training. The training was completed on May 18, 2022.

· Section 102416(c) Personnel records review confirmed that the co-licensee, Tran Quach, Pediatric FirstAid CPR was not valid. Ms. Quach has completed her Pediatric FirstAid CPR training with the new expiration date of May 2024.

· Health and Safety Code section 1597.622(a)(1); Based on record review, both licensees did not have immunization records on file or records available for review. During today's visit, LPA reviewed both licensee records and found that both have up-to-date immunization records, including TB clearance, MMR, tdap, and influenza.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: QUACH, NGOC TRAN & TRUONG, HUE LINH
FACILITY NUMBER: 380505659
VISIT DATE: 06/16/2022
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All deficiencies cited on May 13, 2022, cleared today, June 16, 2022.

An exit interview was conducted with the Licensee, and a consultation was provided. In today's inspection, no deficiencies were observed. The Licensee, Truong Hue Linh, signed the report. Today's report, June 16, 2022, a notice of site visit, and a copy of the Letter of Deficiencies Citations will be sent to the Licensee email by the close of business on June 16, 2022. Confirmation of receipt is required. LPA instructed the Director that the site visit notice had to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
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