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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004518
Report Date: 01/25/2022
Date Signed: 01/25/2022 03:42:46 PM

Document Has Been Signed on 01/25/2022 03:42 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:GE, MENGHANFACILITY NUMBER:
414004518
ADMINISTRATOR:GE, MENGHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 766-3018
CITY:BURLINGAME,STATE: CAZIP CODE:
94010
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
01/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Menghan GeTIME COMPLETED:
03:45 PM
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On January 25, 2022, Licensing Program Analyst (LPA), Van, conducted an unannounced annual inspection and met with Licensee, Menghan Ge, and two helpers. The purpose of the inspection was explained and granted entry to the home by the Licensee. Licensee has nine children in care, three infants and six preschoolers. All adults living in the home or working at the daycare have cleared criminal records. This facility is a two stories single-family house. Licensee rents this house. Daycare areas are on the ground level floor, including the kitchen, the bedroom, the dining room, the play area (located on the right side of the house), and the living room. The garage, the entire second-floor level, and the backyard are off-limit areas. Days and operation hours are 8:00 am – 6:00 pm, Monday - Friday. Per Licensee, sick children will be separated from the group and wait in the bedroom for the parent to pick them up.

LPA and Licensee inspected the daycare areas for health and safety hazards during the inspection. LPA observed the following; The daycare area is clean, orderly, and equipped with age-appropriate toys and equipment. The home has adequate lighting and ventilation. The daycare has a working smoke alarm, carbon monoxide detector, and a fully charged fire extinguisher. First aid supplies are available for children. Infants have their individual cribs. LPA observed no blanket, pillows, toys, or anything hanging above the infants' cribs. The Licensee had posted all the required forms, such as facility License, Notification of Parent's Rights, Earthquake preparedness checklist, and Notification of Personal Rights. Per Licensee, there are no firearms, weapons, or pets in the home. All cleaning, disinfectants, or chemicals are stored in the kitchen's cabinets with childproof latches installed. The Licensee states breakfast, lunch, morning and afternoon snacks are provided to the children. Children bring their water bottles from home, labeled with their names. Licensee also has a water pitcher available for children if they forget their bottle. LPA observed no pools, spas, or other bodies of water on the premises. Per Licensee, fire drills are conducted and documented accordingly, and the last fire drill was conducted on August 6, 2021.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2022
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: GE, MENGHAN
FACILITY NUMBER: 414004518
VISIT DATE: 01/25/2022
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During the inspection, LPA reviewed all records of children and staff that were present. LPA observed that the Licensee maintained records of each child accordingly; identification and emergency information, consent for medical treatment, and parent's rights were appropriately completed. Infants' napping record was kept and documented properly, and infants under twelve months old have Infant Sleeping Plan on file. The Licensee has maintained a record of immunization. LPA observed mandated reporter training certification, and Pediatric FirstAid & CPR for all staff are current, except for one helper. Per Licensee, the helper language barrier and limited CPR class in Chinese due to the COVID 19, the helper was not able to renew on time but was recently able to schedule one class for January 29, 2022.

Licensee was reminded that all adults 18 and over living or working in the home, 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 the 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 purchased equipment.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
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: GE, MENGHAN
FACILITY NUMBER: 414004518
VISIT DATE: 01/25/2022
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LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

The report was reviewed and signed by the Licensee, Menghan Ge. No deficiencies were observed in today's inspection. Today's report, 1/25/2022, and notice of site visit will be sent to the Licensee email by the close of business on 1/25/2022. Confirmation of receipt is required, and a notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2022
LIC809 (FAS) - (06/04)
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