384001678-2-7-2023-05-CC-JYEE-CNTS8X-20230207123953

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001678
Report Date: 02/07/2023
Date Signed: 02/07/2023 12:40:07 PM

Document Has Been Signed on 02/07/2023 12:40 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	HERRERA, MARIA TERESA & DARSY YANINA		FACILITY NUMBER:	384001678
ADMINISTRATOR:	HERRERA, MARIA T. & DARSY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 585-2185
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94112
CAPACITY:	14	CENSUS: 12	DATE:	02/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Darsy Yanina, Elviar Tuyub		TIME COMPLETED:	01:15 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	Licensing Program Analysts (LPA) Yee conducted an annual required inspection today. LPA rang the doorbell several times and knocked on the door several times. No answer. A phone call was made several times. No answer. I heard kids crying inside. Finally, the licensee, Darsy called and said she is out on a Dr. appointment and will return to meet up with LPA. LPA waited for Darsy outside of the facility. At 10 am Darsy arrived. The purpose of the inspection was explained. We both went inside the facility. LPA observed helper, Elvira with 12 children by herself. Darsy said her other helper called in sick this morning. Her mother, the original licensee, Maria Teresa Herrera has been out of the country for a few years. Darsy said Maria is retired. Co-licensee, Darsy Yanina Herrera will submit a new application by the end of next week. LPA and Licensee toured the daycare areas. The facility personnel summary report was reviewed with Darsy and she said it is current. The facility phone numbers and email addresses were verified with Darsy. She said it is correct. All adults living or working in the home have criminal background clearance on file. The current residents at the facility are Darsy and her husband. The licensee provides day care from Monday to Friday between 9:00 AM to 5:45 PM. Day Care Areas:(lower level): garage converted into day-care, classroom #1, dining room, side bedroom used as an infant nap room, and backyard. The backroom is used as storage and off-limit. The entire upper level is off-limit. There is no body of water such as a swimming pool, or hot tub on the premises. Cleaning supplies, poisons, and other chemicals are stored out of reach of children. The house is in good repair and free of hazards with proper temperature and ventilation. There is a carbon monoxide detector, smoke detector fully charged fire extinguisher, and working telephone available in the house. There is a variety of age-appropriate toys in the house.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HERRERA, MARIA TERESA & DARSY YANINA	FACILITY NUMBER: 384001678
	VISIT DATE: 02/07/2023

NARRATIVE

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LPA reviewed the children's records and is in order. Licensee's CPR and 1st aid card is current until 09/2023. The last fire drills were conducted on 01-07-2023. A log sheet was reviewed. Roster was reviewed during the visit.

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 an 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.

LPA discussed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Licensee, Darsy AB1207 certificate has expired. Darsy will renew and will submit to CCL by the end of this month.

Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/

LPA discussed the safe sleep regulations with the 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. LIC9227, Infant sleep log was explained and provided.

Notice of Site Visit posted and shall remain posted for 30 days. As proof of review form LIC9224 will then be given to all current parents for signature and be kept in each child's file. For the next 12 months all parents shall also be provided information contained in this report and a copy of the LIC9224 will also be signed and placed in each child's file .)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/07/2023 12:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: HERRERA, MARIA TERESA & DARSY YANINA	FACILITY NUMBER: 384001678
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102391(c)

Inspection Authority of the Department

(c) The licensee shall permit the Department to inspect any part of the family child care home in which family child care services are provided or to which children have access. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. LPA informed the licensee if this happened again civil penalty of $500 will be issued.
	POC Due Date: 02/07/2023
	Plan of Correction
1 2 3 4	Licensee stated that she will tell her helper to answer the door moving forward.

Type A

Section Cited

CCR

102416.5(d)

Staffing Ratio and Capacity

(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	created in error.
	POC Due Date: 02/07/2023
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/07/2023 12:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: HERRERA, MARIA TERESA & DARSY YANINA	FACILITY NUMBER: 384001678
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(e)

Staffing Ratio and Capacity

(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 02/07/2023
	Plan of Correction
1 2 3 4	The licensee arrived at the facility in half hours. The deficiency is cleared.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 02/07/2023 12:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: HERRERA, MARIA TERESA & DARSY YANINA	FACILITY NUMBER: 384001678
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)(D)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/07/2023
	Plan of Correction
1 2 3 4	A blank sheet of infant log sheet was provided. The licensee will document every 15 minutes moving forward. She will keep the log sheet for 2 years.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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