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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002537
Report Date: 11/14/2019
Date Signed: 11/14/2019 04:05:18 PM

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: 6DATE:
11/14/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Alexandre PinheiroTIME COMPLETED:
04:30 PM
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1, Licensing Program Analyst, LPA Yee conducted a case management inspection today. I met with two helpers, 6 children. Licensee, Alexandre Pinheiro arrived during the inspection. The purpose of the inspection was explained. The facility personnel summary report was reviewed with Mr. Pinheiro. He said it 's correct. Current residents at the facility are licensee, Alexandre, 1 roommate, and his 2 daughters ages 13 yr old and 7 yr old. LPA toured and did a physical inspection today with Mr. Pinheiro. No change in the daycare areas. Day-care areas (upper level): Dining room, bedroom #1, hallway bathroom and backyard. The remaining areas of the house are off-limits. The CPR, 1st aid for helpers and licensee are current. The required immunization is on file. All staff members have Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/ certificate on file. SIDS " A Child Care Provider's Guide to Safe Sleep" information was provided in English and Spanish.

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

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
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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