384000908-10-10-2023-05-CC-CMOK-CWGPM3-20231010112541

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000908
Report Date: 10/10/2023
Date Signed: 10/10/2023 11:26:29 AM

Document Has Been Signed on 10/10/2023 11:26 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:	CHINCHILLA, LISA M.		FACILITY NUMBER:	384000908
ADMINISTRATOR:	CHINCHILLA, LISA M.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 333-5323
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94127
CAPACITY:	14	CENSUS: 9	DATE:	10/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Lisa Chinchilla		TIME COMPLETED:	11:55 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	Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the helpers who had fingerprint clearance upon LPA's arrival. Per one of the helpers, the licensee, Lisa, left the house to drop off her children. The licensee came home approximately 15 minutes after LPA arrived. All adults had fingerprint clearance. The facility had 9 children including 4 infants present with 2 helpers. The facility is called " Little Leaps & Bounds" and the operation hours are Tuesday to Friday from 8:30 AM to 4:30 PM. Licensee owns this 2 stories single-family house and lives with her husband and 4 minor children. The daycare areas are the entire lower level including playrooms #1, #2, and #3, a bathroom, and a backyard. The off-limit areas are the entire upper level and a carport. The main daycare entrance is on the left side of the house, children need to enter the daycare from the side yard with a gate. LPA inspected the facility for health and safety hazards. The facility was clean and in order. Temperature and lighting were adequate. The licensee made the toxins and harmful objects inaccessible to the children in the daycare areas. The facility had a working smoke and carbon monoxide detector, a working cellular phone, a fully charged 2A10BC fire extinguisher, and first aid supplies available. The licensee installed a gate at the entrance of playroom #2 to prevent children from accessing the off-limit areas. The facility had plenty of age-appropriate toys, books, learning materials, and equipment, and children's furniture that was in good condition and repair. The facility had the right amount of cubbies and hooks with children's names for the children to store their belongings by the entrance of playroom #2. Childproof knob was installed at the door to the carport. All electrical outlets were covered. Play pens and cots were used for napping. A diaper changing table was available in playroom #3 that next to the children's bathroom. The children's bathroom was clean and in order. The lower bathroom sink cabinet and drawers were free of harmful objects. The outdoor play yard was completely fenced. The licensee installed turf to the outdoor ground for soft cushioning to prevent injury. It had plenty of outdoor toys, ride-on toys, a play house, a water table, and a slide structure that was placed on the top of the turf area to prevent injury. Per the licensee, children have brought their meals to the daycare daily. Per the licensee, she had no guns and weapons in the house, but she had a dog that was kept in the off-limit areas. Per the licensee, there were no children on special medication. Per licensee, disaster drill has been conducted quarterly. The licensee posted the required postings in the daycare areas. The licensee and helper had current CPR/First Aid training, which will expire on 2/2025, 2/2025 & 11/2024, and Child Abuse Mandated Reporter Training, which will expire on 12/2024. LPA reviewed the children's files and obtained a copy of the current children roster during the inspection. Continuous on LIC 809C

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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 3

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: CHINCHILLA, LISA M.	FACILITY NUMBER: 384000908
	VISIT DATE: 10/10/2023

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
26
27
28
29
30
31
32

Criminal Record Clearance - Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Safe Sleep - LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

MyChildCarePlan.org – 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.

Megan’s Law - 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. PIN 22-05-CCP Page Five

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CHINCHILLA, LISA M.	FACILITY NUMBER: 384000908
	VISIT DATE: 10/10/2023

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
26
27
28
29
30
31
32

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the licensee, Lisa Chinchilla.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3