214005170-2-8-2024-05-CC-NGAA-D29RLJ-20240208120712

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005170
Report Date: 02/08/2024
Date Signed: 02/08/2024 12:07:23 PM

Document Has Been Signed on 02/08/2024 12:07 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:	SALIMI, SADAF		FACILITY NUMBER:	214005170
ADMINISTRATOR:	SALIMI, SADAF		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 883-6255
CITY:	NOVATO	STATE: CA	ZIP CODE:	94949
CAPACITY:	14	CENSUS: 8	DATE:	02/08/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	SADAF SALIMI		TIME COMPLETED:	12:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On February 8, 2024, Licensing Program Analyst (LPA) Garcia arrived at the facility to conduct an unannounced required Inspection and met with the Licensee, Sadaf Salimi. Purpose of the inspection was explained. There were 8 children with the licensee, and two employees present in the home. LPA verified the background check clearance of all the adults working or living in the home. The hours of operation are Monday through Friday, 8:00 AM - 5:00 PM. Licensee provides breakfast, morning snacks, lunch, afternoon snacks and early dinner. Water is provided through kitchen sink dispenser and refilled as needed. Daycare areas: living room #1 and #2, dining room, bathroom and backyard. Off Limit areas: bedroom #1, #2, #3 and 2 bathrooms, garage and kitchen. All are located at the entire upstairs area. LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care. LPA and Licensee inspected the entire childcare area for Health and Safety hazards. There is a carbon monoxide and smoke detectors located in each living room. LPA Garcia did not perform the tests to check the functionality of the detector due to high ceilings. However, LPA observed that light is on for the detectors. One fully charged fire extinguisher of size 3A40BC was also available in the home, located in the kitchen counter. First Aid kit is fully stocked and accessible. Licensee states there are no guns or weapons and no open bodies of water in the home. There are also no pets in the home. LPA observed that the house is in good repair and free of hazards with proper temperature and ventilation and lighting. Electric outlets have proper covers and a working phone is on site. The Licensee has 'Estate National Insurance' available. LPA observed that the day care area has multiple play set materials with play sets and neatly organized. LPA and Licensee inspected the backyard and observed that there are multiple play cars for children to ride in, age appropriate structures and play houses, toys, and cars. The backyard play area is clean with wood chips, mud kitchen, benches and high fences. LPA observed that there are variety of age-appropriate toys, books, and other learning materials available in the home. *continue to page 2*

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SALIMI, SADAF	FACILITY NUMBER: 214005170
	VISIT DATE: 02/08/2024

NARRATIVE

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All posting requirements are met and posted near the childcare entrance. Licensee has current and valid CPR and First Aid card expiring on 02/2025. Licensee and employees also possess Mandated reporter training certificates, which expires 9/2025. LPA reviewed facility records. 4 children's records, Licensee's were reviewed and complete. The facility conducts fire and earthquake drills with the children at least every other month. LPA observed that one of the employees did not have documents for immunization due to her recent arrival and will be an Advisory note. The most recent one was on December 15, 2023.

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.

Per Licensee, there are no children enrolled with allergies. Incidental Medical Services (IMS) policy was discussed. For IMS information 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: on see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the www.ada.gov/childqanda.htm.

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 Licensees. 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. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.
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SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SALIMI, SADAF	FACILITY NUMBER: 214005170
	VISIT DATE: 02/08/2024

NARRATIVE

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LPA encouraged the Licensee to visit the Licensing 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.

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 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.

Licensee 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.

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

A copy of this report was given to the Licensee and a site visit notification must be posted for 30 days.

LPA reminded licensee to not have covers on cribs and no pacifiers with strings attached.

>No Deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

Technical Assistance for employee immunization records.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Sadaf Salimi.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

LIC809 (FAS) - (06/04)

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