<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005422
Report Date: 02/07/2024
Date Signed: 02/07/2024 09:55:23 AM


Document Has Been Signed on 02/07/2024 09:55 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:
02/07/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:Damaris VasquezTIME COMPLETED:
10:05 AM
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 2/7/2024, Licensing Program Analyst (LPA) Hanson Leong made an unannounced case management visit to the Family Child Care Home listed above. During today’s visit, LPA met the Licensee, Damaris Vasquez. The purpose of today's visit is to inform the licensee that their complaint report from 1/4/2024 has been amended. Present in the home included the licensee, five preschool-aged children, and two infants. The home operates within its capacity and in accordance with the required ratio of staff to children.

The licensee read, understood, and signed the amended report from 1/4/2024.

No deficiencies were issued today during LPA's visit.

A copy of today's report was given to Damaris Vasquez.

A Notice of Site Visit was given and must remain posted 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: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1