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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002537
Report Date: 07/16/2019
Date Signed: 07/16/2019 11:50:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PINHEIRO, ALEXANDREFACILITY NUMBER:
384002537
ADMINISTRATOR:PINHEIRO, ALEXANDREFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 771-1004
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 8DATE:
07/16/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Alexandre PinheiroTIME COMPLETED:
12:15 PM
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3, Licensing Program Analyst, LPA Yee conducted an annual required inspection today. The purpose of the inspection was explained. There are 8 day-care children, licensee's two children ages 12-year-old, 7-year-old, licensee, and 2 helpers present today. Current residents at the facility are licensee, Alexandre, 1 roommate, and his 2 daughter ages 12 yr old and 7 yr old. Facility personnel summary report was reviewed with Alex and he said it's correct. Day-care areas (upper level): Dining room, bedroom #1, hallway bathroom and backyard. The remaining areas of the house are off-limits. The home is equipped with a fire extinguisher, smoke detector, and Carbon Monoxide detector. Licensee and helper have current CPR and 1st aid certificate until on file which expires 11/2020 and 6/2021. Children files and roster were reviewed. The licensee and helpers have required immunization on file. 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.
Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/. One helper has AB1207 certificate. Alex said he took the class but unable to find the certificate. He will submit the certificate to LPA by the end of next week. SIDS "A Child Care Provider's Guide to Safe Sleep" information was provided in English and Spanish.

LPA used Google Spanish translation and also offer Language Links translation. Licensee said after reading Google Spanish translation, he said he understands the report and no need to call Language Links service.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
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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