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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384003070
Report Date: 06/21/2021
Date Signed: 06/21/2021 12:29:27 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:ROSILLO, ANGELINA A.FACILITY NUMBER:
384003070
ADMINISTRATOR:ROSILLO, ANGELINA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 418-8563
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:14CENSUS: 4DATE:
06/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Angelina RosilloTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced required annual inspection today. LPA met with the licensee, Angelina Rosillo, who has fingerprint clearance. LPA explained the purpose of the inspection to her. The licensee, Angelina Rosillo, became a sole licensee on 6/11/2020 per licensee request. The primary licensee, Annmarie Cervantes, is no longer a licensee. There were 4 children included 1 toddler present. The Licensee rents this two stories single-family house. The licensee lives in the house with a dog which is vaccinated. The operation hours of the facility are Monday to Friday from 8AM TO 5:30PM. The daycare areas include the entire lower level except for the kitchen, cottage, & garage. The off-limit areas are the entire upper level, kitchen cottage, and garage. LPA toured and inspected the facility for health and hazard. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. Cubbies were available for the children to store their belongings by the main entrance. There were plenty of age-appropriate toys, books, learning material, art and craft material, and children's furniture available for the children. There was a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detectors, and first aid supplies available in the daycare. Per licensee, there were no guns, and weapons at home. The facility provides breakfast, AM/PM snacks, & lunch to the children. Playpens and sleep bag with cushion were available for napping. All electrical outlets were covered. The licensee installed the soft cushions on the daycare floor to prevent injury. The children's bathroom was clean. The lower bathroom cabinet was blocked and free of dangerous items. Gates were installed at the hallway between living room, dining room, and kitchen area. The outdoor play yard was completely fenced. There were some age-appropriate outdoor toys a playhouse, water table, and children’s furniture available for the children. A gate was installed a the deck to prevent children access to the cottage area. The fire drill is conducted 2 times a year with the children. The Licensee had current CPR/First Aid training certificates and Mandated Reporter Training (AB1207) available for review during the inspection. The certificates will expire in 9/22 and 8/21. There were no children on special medication. This facility provides Incidental Medical Services - IMS. LPA reviewed storage of the medication, equipment/supplies and reviewed children's, personnel, and administrative records. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care facilities and the ADA, available at: http://www.ada.gov/childqanda.htm. The facility had hand sanitizer, Thermometer, and disinfectant available in the daycare area to prevent COVID19. The hand sanitizer and disinfectant must be stored in a higher place to prevent children's access to them. All required postings were posted. Children's files were reviewed during the inspection.
LPA also obtained a copy of the current children roster from the licensee during the inspection.

This report and notice of the site visit were discussed with the licensee. The licensee must be made it available to the public upon request. LPA provided A Child Care Provider's Guide to Safe Sleep to the licensee during the inspection. For a quarterly update on Licensing information, go to the CCL website: www.ccld.ca.gov. For Provider Information Notice:
ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
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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