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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004595
Report Date: 11/28/2023
Date Signed: 11/28/2023 04:27:01 PM

Document Has Been Signed on 11/28/2023 04:27 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:WANG,YANFACILITY NUMBER:
384004595
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
11/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Yan WangTIME COMPLETED:
04:45 PM
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Licensing Program Analyst, LPA Yee conducted a case management visit today. The facility has requested to increase her capacity from a small capacity to a large capacity. Fire clearance was approved on 11/13/2023. LPA and Yan Wang toured the daycare areas. There are four infants in care today. Total children enrolled are 4.

Daycare areas (lower level): play room #1, play room #2, nap room, kitchen, greeting room (front), bathroom and backyard. The remaining of the house are off limits. CPR, 1st aid is current until 05/13/2025.

Safe sleep regulations was discussed and provided. Capacity worksheet was discussed and provided. For a large license the facility needs to have a helper to operate her large daycare. Without a helper, the facility can only operate as a small license. All required document for the helper must be on file and helper needs to have fingerprint clearance prior to having contact with children. Yan Wang said she understands.

Based on today's inspection, large license is approved effective today, 11/28/2023.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2023
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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