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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005105
Report Date: 01/05/2024
Date Signed: 01/05/2024 03:12:52 PM


Document Has Been Signed on 01/05/2024 03:12 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:FIGUEROA, ESLYFACILITY NUMBER:
214005105
ADMINISTRATOR:FIGUEROA, ESLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 256-9101
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:14CENSUS: 5DATE:
01/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Esly FigueroaTIME COMPLETED:
03:25 PM
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On 1/5/2024, Licensing Program Analyst (LPA) Hanson Leong made an unannounced case management visit to the Family Child Care Home listed above. The purpose of the visit was to confirm whether S2, who was waiting for fingerprint clearance, lived in the home. The LPA was granted entry by the Licensee, Esly Figueroa. Ms. Figueroa was informed of the reason for today's visit by the LPA. Present in the home included Ms. Figueroa, Ms. Figueroa’s assistant, Ms. Figueroa’s son, two preschool-aged children, and three infants. All individuals present in the home have been granted permission to work or be in a Family Child Care Home. The home operates within its capacity and in accordance with the required ratio of staff to children.

According to Ms. Figueroa, S2 does not reside in the house. The LPA conducted a thorough inspection of the home, but S2 was not found on the premises. The LPA reminded Ms. Figueroa that S2 cannot reside in the home until their fingerprints are cleared.

Ms. Figueroa 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.

No deficiencies were cited today under CCR, Title 22, Div. 12.

A copy of today’s report was given to Esly Figueroa. A Notice of Site Visit was given to Esly Figueroa and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with Esly Figueroa

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson LeongTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/05/2024
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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