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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005278
Report Date: 03/07/2024
Date Signed: 03/07/2024 03:09:28 PM


Document Has Been Signed on 03/07/2024 03:09 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:MAJOULET, HEATHERFACILITY NUMBER:
214005278
ADMINISTRATOR:MAJOULET, HEATHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 225-5770
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY:14CENSUS: 3DATE:
03/07/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:49 PM
MET WITH:Tamra BroussardTIME COMPLETED:
03:20 PM
NARRATIVE
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On March 7, 2024, Licensing Program Analyst (LPA) Garcia, conducted an unannounced plan of correction (POC) visit to facility. LPA met with licensee's assistant, Tamra Broussard and explained the purpose of the visit. Per Tamra, the licensee is not present in the home and is picking up children from school and won't be back for another hour. LPA contacted Licensee, Heather Majoulet to let her know about today's visit and asked about the CPR certification.

On December 14, 2023, LPA met with licensee to conduct an unannounced, annual inspection at facility. During annual inspection, Licensee was cited for not having a valid CPR/First Aid training certificate and planned a POC due 1/15/24. LPA Garcia contacted the licensee on 2/20/24 to follow up on the POC and according to her, she is scheduled for a training and will send a verification of the appointment through email at the end of that day. LPA did not receive an email from Licensee.

As of this date, LPA contacted the Licensee, Heather Majoulet over the phone and according to the licensee, she sent the new CPR training certificate to the wrong email address. LPA confirmed from that phone conversation the correct LPA email address and to send the valid CPR/First Aid training certificate. LPA received the CPR certificate issued on March 2, 2024.

Deficiency cited on 12/14/2023 has been cleared. LPA provided facility representative copy of POC letter.

A notice of site visit was given and must remained posted for 30 days. Appeal rights were provided during visit.

Exit interview conducted and report was reviewed with Tamra Broussard.
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2024
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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