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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004260
Report Date: 05/03/2022
Date Signed: 05/03/2022 02:51:16 PM

Document Has Been Signed on 05/03/2022 02:51 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:CHEN, DANTONGFACILITY NUMBER:
384004260
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/03/2022
TYPE OF VISIT:Required - 1 YearANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Dantong ChenTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Mok conducted an announced annual inspection. LPA met with the licensee, DanTong Chen (Dorothy). The purpose of the inspection was explained to her. There were no children present. Per licensee, she hasn't accepted any child during the Pandemic. Per licensee, she has started to enroll the children, but she hasn't had any enrolled child yet. LPA toured the facility for health and safety hazards. All adult residents have fingerprint clearance. The licensee owns the 2 stories level single-family house. The licensee lives in the house with her husband, her 2 sons (minor), her mother-in-law, and 3 tenants. The house has 3 bedrooms, 2 bathrooms, living room, dining room, and kitchen on the upper level; 4 bedrooms, 2 bathrooms, entertainment room, garage, and backyard on the lower level. The daycare areas are the living room, dining room, and bathroom #1 (it is next to the kitchen). The off-limit areas are all bedrooms, bathroom#2 (it is next to the mother-in-law's bedroom -#3), and the entire lower level. There were plenty of age-appropriate toys, slides, books, learning material, and children's furniture available for the children. Gates were installed between the living room and dining room, and kitchen entrance to prevent children access to the off-limit area. Childproof knobs were installed to the bedroom doors to prevent children's access to the off-limit. All sharp corners were covered. All electrical outlets were covered. Window locks were installed to the windows in the living room, they limit the windows to be opened up to 4 inches. The fireplace was latched and blocked by a big toy. Soft cushioning was installed to the floor to prevent injury in the living room. Cubbies were available by the main doorway for the children to store their belongings. There was a fully charged 2A10BC fire extinguisher, working cellular phone, working 2-in-1 smoke and carbon monoxide detectors, and first aid supplies available in the house. Per licensee, she plans to open her backyard for the daycare. but she will contact CCL whenever it's ready to be inspected. All the postings were posted.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. ForProvider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2022
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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