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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002652
Report Date: 05/03/2023
Date Signed: 05/03/2023 03:31:38 PM


Document Has Been Signed on 05/03/2023 03:31 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:BOSCHINI, JUDITHFACILITY NUMBER:
384002652
ADMINISTRATOR:BOSCHINI, JUDITHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 322-0278
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:14CENSUS: 4DATE:
05/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Judith BoschiniTIME COMPLETED:
03:40 PM
NARRATIVE
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On 5/3/2023 at 1:25PM., Licensing Program Analysts (LPA), Luis J. Gomez met with Licensee, Judith Boschini. Purpose of the inspection was explained and was for an Unannounced; Annual Random inspection. Present in facility was the licensee caring for 4 children. Adults present have criminal record clearances on file. Children presents are preschool age. Per licensee, preschool age child present is her daughter. Licensee’s home is a three bedroom, two bathroom, one level house. Days and hours of operation: Monday- Friday, 7:30AM. to 5:00PM. Daycare Areas are: Living Room (Playroom), Bathrooms #1, #2, Kitchen (Pass through only), Dining Room, Bedroom #1, #2 and Backyard. Off limit areas are: Bedroom #3/ Storage/Converted Garage in Backyard. LPA inspected home, inside and outside, for health and safety hazards.

At 1:30PM., the following was observed: Facility had age-appropriate playthings available for the children. Accessible furniture, toys and books inspected were in good repair. Individual cubbies available for children belongings.
At 1:40PM., Based on observations, LPA confirmed children's toys and playthings on floor/ ground in backyard area, bedroom #1 and living room (playroom), near facility exit.

Facility has child sized table and chairs for meals and seated activities. For napping services, LPA observed several cots, located in bedroom #1. Per licensee, napping sheets are washed weekly. Bathroom #1 had adequate supplies for hand washing. Cabinets in bathroom #1 have safety locks installed. Facility was the proper temperature, with ventilation, and lighting. Home had functioning telephone service; smoke/ carbon monoxide combination detector; and fire extinguisher, 2A:10BC.

LPA inspected backyard area. Area is completely enclosed with tall fencing and is free of hazardous plants. Home does not have any pools, fishponds, jacuzzis, or bodies of water.
At 1:45PM, Based on observations, LPA confirmed accessible laundry detergent containers in the on-limit areas.
(REFER TO 809C, FOR CONT)
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
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 5


Document Has Been Signed on 05/03/2023 03:31 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: BOSCHINI, JUDITH
FACILITY NUMBER: 384002652

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(b)
Operation of A Family Child Care Home
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 1:40PM., Based on observations, LPA confirmed children's toys and playthings on floor/ ground in backyard area, bedroom #1 and living room (playroom) near facility exit. This poses a potential health and safety risk to children in care.
POC Due Date: 05/08/2023
Plan of Correction
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Licensee will remove all toys from ground/ floor in living room (playroom), backyard area and bedroom #1 by due date: 5/8/2023. Proof of correction will be submitted to the department via email.
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 1:45PM, Based on observations, LPA confirmed accessible laundry detergent containers in the on-limit areas. This poses a potential health and safety risk to children in care.
POC Due Date: 05/05/2023
Plan of Correction
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Licensee will remove accessible detergents from on-limit/ day-care areas by the due date: 5/5/2023. Licensee will submit proof of correction to department via email.
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 ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5


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: BOSCHINI, JUDITH
FACILITY NUMBER: 384002652
VISIT DATE: 05/03/2023
NARRATIVE
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(Page 2)
At 2:00PM, LPA reviewed facility and children’s records. Children’s files were reviewed and included the: Identification of Emergency Information (LIC700); Notification of Parent's Rights (LIC995); Immunization Record; and Consent for Medical Treatment (LIC627).

Licensees required 'Mandated Reporter Training' certification (AB1207) was current, expiring 5/20/2024.


Licensee’s Cardiopulmonary Resuscitation (CPR)/ First Aid certification was current, expiring: 6/2024.

LPA reminded licensee to conduct disaster drill every six month. Advisory Note: Technical Violation (LIC9102TV) was issued.

Required posting are entry way: including Childcare License, Notification of Parent’s Rights (PUB379), and Emergency Disaster Plan (LIC610A),

Per licensee, isolation of ill children is in playroom.

Per licensee, families provide all snack, foods services for children in care. LPA advised licensee to ensure all children’s meal containers brought by families must be labeled. Per licensee, home does not have firearms.

Licensee was reminded that all adults 18 years and over, living or working in the home, including employee and volunteers, must obtain criminal 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 up to $500.00 maximum per day/ per person will be assessed if this regulation is violated.


(REFER TO 809C, FOR CONT.)
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: BOSCHINI, JUDITH
FACILITY NUMBER: 384002652
VISIT DATE: 05/03/2023
NARRATIVE
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(Page 3)
LPA discussed the safe sleep regulations with licensee and discussed Child Care Licensing Safe Sleep Web page at:https://www.cdss.ca.gov/inforesource/child-care-licesning/public-information-and-resources/safe-sleep as an additional resource. LPA informed licensee of the importance of checking for recalled infant devices on United States consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will 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 tool, please send them 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/inforesource/community-care-licensing/inspection-process.

Based on today's inspection, deficiencies were observed in areas evaluated according to California Title 22, Div. 12 Chap. 3 Health and Safety Code of Regulations and cited on 809D. During exit interview, licensee's appeal rights, plans for correction, and report was discussed with Licensee, Judith Boschini and signature of this form acknowledges receipt of these documents.

Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5