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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004541
Report Date: 10/01/2025
Date Signed: 10/01/2025 05:45:16 PM

Document Has Been Signed on 10/01/2025 05:45 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:WU, LEILEIFACILITY NUMBER:
414004541
ADMINISTRATOR/
DIRECTOR:		WU, LEILEIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 417-5342
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
10/01/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Lishao MaiTIME VISIT/
INSPECTION COMPLETED:
06:00 PM
NARRATIVE
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On 10/1/2025 at 1:50 PM, Licensing Program Analysts (LPAs) Wadhwa and Tso conducted an unannounced, annual inspection. LPAs met with Licensee’s staff member (S1), Lishao Mai, explained the purpose of the visit. Present during LPA's visit included S1, another assistant (S2), and 5 children (2 infants and 3 preschool age children). Per S1, Licensee is away for two days (10/1/2025 and 10/2/2025) on
personal issues.
The facility's hours of operation are Monday to Friday 8:00 AM to 6:00 PM. LPAs conducted a health and safety inspection inside and outside the home. The home is a single-family home. Entrance to the facility is through the front door.

DAY CARE AREAS include living room (main playroom), dining room, bedroom #1 and bathroom #1 and the backyard.
OFF LIMIT AREAS are the kitchen, bedroom #2 and #3, the garage and bathroom #2. Off-limit areas are made inaccessible with child safety gates or doors that remain closed.

LPAs observed home to be clean and well ventilated. Home is equipped with furniture, toys and equipment that were observed to be age appropriate. LPAs observed electrical outlets to be made inaccessible with child safety covers. LPAs observed cleaning supplies, poisons, and other chemicals to be inaccessible behind child safety locked cabinets or located in off-limits areas.

LPAs observed the bathroom to be in proper working condition, with appropriate sanitation products. Cabinets and drawers are made inaccessible to children with multiple child safety locks. Home is equipped with a first aid supply kit, fire extinguisher 3A40BC, a smoke detector and a carbon monoxide detector, which LPAs tested.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 10/01/2025 05:45 PM - It Cannot Be Edited


Created By: Ruhi Wadhwa On 10/01/2025 at 04:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WU, LEILEI
FACILITY NUMBER: 414004541

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
Based on record review and verification on Guardian website, one staff S2 employed since June 2024 and present on this day, does not have a criminal record clearance.
POC Due Date: 10/02/2025
Plan of Correction
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LPAs advised facility representative, S1, that a criminal record clearance or exemption for staff must be obtained, prior to initial presence in a childcare home.
LPAs advised that S2 should not return to the facility until crimal record clearance has been obtained.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Ruhi Wadhwa
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2025


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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WU, LEILEI
FACILITY NUMBER: 414004541
VISIT DATE: 10/01/2025
NARRATIVE
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LPAs did not observe any pools, spas or bodies of water on site. LPAs inspected the outdoor play area and observed a rusted mesh lining with sharp metal edges on the raised wooden patio, LPAs also observed the shade canopy frame was severely corroded and shook upon touching during the inspection. LPAs advised facility representative S1, to fix or remove the structure entirely. Advisory Note: A Technical Violation (LIC9102TV) was issued.

Per S1, Licensee provides a food service which includes, a hot lunch, a morning and an afternoon snack to children in care. Licensee also provides milk and water to children in care. LPAs inspected kitchen/food storage and found food items to be current and properly stored.

Per S1, cribs or cots are provided by the facility and bedding is provided by parents. Bedding is sent home weekly to be laundered.

Per S1, there are no weapons or firearms in the home. Emergency drills are conducted regularly and are properly logged. Last emergency disaster drill was conducted on 9/30/2025. LPAs observed licensing documentation to be properly posted and made available for review. LPAs reviewed the 15-minute sleep logs for two infants and found them to be conducted and documented properly.

LPAs reviewed facility records that included 5 children files, 3 staff files including the licensees’ file.

Based on record review, an infant under the age of 1 year, did not have form LIC9227 available for review today. Advisory Note: Technical Violation (LIC9102TV) was issued.

Based on record review and verification on Guardian website, one staff S2 employed since June 2024 and present on this day, does not have a criminal record clearance. LPAs advised facility representative, S1, that a criminal record clearance or exemption for staff must be obtained, prior to initial presence in a childcare home.

Based on information stated above, the facility will receive a Type A citation for employing uncleared staff, in accordance with the Title 22 Division 12 of California Code of Regulations. See LIC 809D.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WU, LEILEI
FACILITY NUMBER: 414004541
VISIT DATE: 10/01/2025
NARRATIVE
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Also, LPAs informed facility representative, Lishao Mai, to provide a copy of this licensing report (10/1/2025) that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed acknowledgement of receipt of Licensing Report (LIC9224), or other written statement, must be placed in the child’s file for verification.

Based on observation and interview, licensee’s absence from the facility on this date exceeded 20 percent of the total hours the facility is licensed to provide care per day. Advisory Note: Technical Violation (LIC9102TV) was issued.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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-andresources/safe-sleep as an additional resource. LPA also informed 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.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WU, LEILEI
FACILITY NUMBER: 414004541
VISIT DATE: 10/01/2025
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPAs discussed Child Abuse Mandated Reporter Training AB1207 with the licensee. As of January 1, 2018 all staff will be required to complete Child Abuse Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

During the exit interview, facility representative confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

A Type A deficiency was issued during today’s visit, 10/01/2025.

A civil penalty of $100 will accessed on this day, 10/01/2025.

A notice of site visit was given and must remain posted for 30 days. A copy of this report with the appeal rights was discussed and provided, and signature of this form acknowledges the receipt of these documents.

Exit interview conducted and report was reviewed with facility representative, Linshao Mai.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025
LIC809 (FAS) - (06/04)
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