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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001977
Report Date: 01/23/2023
Date Signed: 01/23/2023 04:16:55 PM


Document Has Been Signed on 01/23/2023 04:16 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:SANCHEZ, MIRNA D.FACILITY NUMBER:
384001977
ADMINISTRATOR:SANCHEZ, MIRNA D.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 641-8426
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:14CENSUS: 3DATE:
01/23/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Mirna SanchezTIME COMPLETED:
04:25 PM
NARRATIVE
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On 1/23/2023 at 3:35PM., Licensing Program Analyst (LPA) Luis J. Gomez met with Licensee, Mirna Sanchez. Purpose of the inspection was explained and was for an unannounced; Plan of Correction inspection. Present was the licensee caring for three children (two infant, one preschool age). LPA inspected facility for health and safety hazards.

During today’s inspection, LPA performed observations, record review, and interviews.

At 3:40PM., LPA inspected the children’s records. Children’s records reviewed contained licensee's documentation for infant napping conditions. Each document included child's name, date, and notation every 15 minutes. Per licensee, she plans to implement safe sleep practices with all infants in care

Deficiency issued on 12/21/2022, has been cleared and ‘Cleared Plan of Correction Letter’ was provided.

Based on today's inspection, no deficiencies were observed in the areas evaluated according to the Title 22, Div.12 Ch.3 Ca. Code of Regulations. Exit interview and report was discussed with Licensee, Mirna Sanchez, and signature of this form acknowledges receipt of these documents.

LPA was unable to print copy of report during inspected. Signed report will be mailed to facility.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Licensee was advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2023
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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