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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005422
Report Date: 01/19/2024
Date Signed: 01/19/2024 10:26:38 AM


Document Has Been Signed on 01/19/2024 10:26 AM - 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:VASQUEZ, DAMARIS E.FACILITY NUMBER:
214005422
ADMINISTRATOR:VASQUEZ, DAMARIS E.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 464-7473
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:14CENSUS: 7DATE:
01/19/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Damaris VasquezTIME COMPLETED:
10:35 AM
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On 1/19/2024, Licensing Program Analyst (LPA) Hanson Leong made an unannounced Plan of Correction (POC) visit to the Family Child Care Home listed above. The purpose of the visit was to follow up with the licensee's visit on 1/4/2024 regarding the facility's Type A violation for overcapacity. The LPA was granted entry by the Licensee, Damaris Vasquez. The licensee was informed of the reason for today's visit by the LPA. Present in the home included the licensee, the licensee’s assistant, and the licensee's son. All individuals present in the home have fingerprint clearance to work or be in a Family Child Care Home.

During today’s visit, the LPA observed the licensee and the licensee’s assistant supervising one infant and six preschool aged children. The home operates within its capacity and in accordance with the required ratio of staff to children. The LPA also observed that all enrolled children’s parent/legal guardian completed the form LIC 9224, Acknowledgement of Receipt of Licensing Reports, in compliance with Child Care Regulations (CCR).

The overcapacity violation, CCR 102416.5(a), cited on 1/4/2024, will be cleared on 1/19/2024.

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

A copy of today’s report and the Cleared POC Letter were given to Damaris Vasquez. A Notice of Site Visit was given to Damaris Vasquez 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 Damaris Vasquez.

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson LeongTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 01/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/19/2024
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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