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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004965
Report Date: 11/16/2023
Date Signed: 11/16/2023 02:44:09 PM

Document Has Been Signed on 11/16/2023 02:44 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:YANG, DANFACILITY NUMBER:
414004965
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 5DATE:
11/16/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:39 PM
MET WITH:Dan YangTIME COMPLETED:
03:00 PM
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On November 16, 2023, at approximately 1:45am, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced, capacity increase inspection. LPA met with licensee, Dan Yang, and explained the purpose of the inspection. Present during inspection included licensee, helper and 5 enrolled children (2 infant and 3 preschool age). Licensee is operating within capacity limits.

The licensee currently rents the home and is currently licensed for a small family childcare home. The licensee applied for a large family childcare home license on October 24, 2023. Fire inspection was conducted on October 31, 2023. Licensee’s one year anniversary is December 02, 2023.

Hours of operation are Monday to Friday from 8:30am to 5:30pm. The DAY CARE AREAS are Living room, dining room, bedroom #4, bathroom, and backyard. The OFF-LIMIT AREAS are Kitchen, garage, bedroom #1, #2, and #3. Living room play area is completely gated to separate from eating/art area. All off limit areas are made inaccessible to children by child safety locks and gates.

LPA observed home to be equipped with a variety of age-appropriate toys and learning materials that are in good condition. Outdoor area is equipped with age-appropriate toys and materials that were also in good working condition. LPA did not observe any pools, spas, or bodies of water on the property. All cleaning supplies, poisons, other chemicals, and sharp objects were stored inaccessible to children on high shelves and/or behind child safety locked cabinets. Per licensee, there are no weapons or firearms in the home.

Home is equipped with a fully charged fire extinguisher, smoke/carbon monoxide detectors and fully stocked first aid kit.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
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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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: YANG, DAN
FACILITY NUMBER: 414004965
VISIT DATE: 11/16/2023
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Capacity limits and ratios for a large family day care have been reviewed with licensee on this date. LPA reminded licensee that an assistant must be present when operating as a large license. LPA reminded licensee when an assistant is not present, licensee must operate as a small license.

The licensee's CPR and First Aid training is current and will expire 07/2024. The licensee's Mandated reporter training is also current and will expire 09/2024. Licensee was reminded baby walkers, bouncer, jumpers, and any other similar items are not to be used for children in care.

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.

During today's visit, no deficiencies were cited.

Prior to approval of large license, the following must be completed:

-Receipt of Fire inspection clearance
-Completion of one year of experience

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with licensee, Dan Yang.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC809 (FAS) - (06/04)
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