414000845-6-27-2023-05-CC-MOLN-CT7N42-20230627100713

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000845
Report Date: 06/27/2023
Date Signed: 06/27/2023 10:07:21 AM

Document Has Been Signed on 06/27/2023 10:07 AM - 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:	GONZALES, REGINA LOUISE		FACILITY NUMBER:	414000845
ADMINISTRATOR:	GONZALES, REGINA LOUISE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 366-1773
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	14	CENSUS:	DATE:	06/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:04 AM
MET WITH:	Regina Gonzales		TIME COMPLETED:	10:22 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On June 27, 2023. Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Regina Gonzales,for an unannounced annual inspection. The purpose of the inspection was explained. Present today was Licensee, helper and 9 children (4 infant and 5 preschool). Licensee is operating within capacity and ratio requirements on this day. Licensee and helper have criminal record clearances on file with the department. Hours of operation are Monday– Friday, 8:00am to 5:00pm. LPA and Licensee toured the home for health and safety hazards. The home is a tri-level home. Day Care Areas: Licensee is currently only using converted garage for daycare, which includes playroom, bathroom and laundry room and located on the ground floor. Laundry room in garage is off limits and door is secured with a child proof doorknob lock. Staircase to upstairs is barricaded with a child proof gate. Off Limits Areas: Entire second and third floor is off limits. The home is clean and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. There are plenty of age-appropriate toys, child size furnishings, learning material and play pens. Backyard is equipped with plenty of child size toys and free of any safety hazards. Deck area is fenced off. Upper backyard is off limits. Childcare area is concrete area and grass area to cushion falls. No spas, pools or other bodies of waters were observed. Entire backyard is completely fenced with a 4’ fence. The home is equipped with a dual working carbon monoxide/smoke detector and a fully charged fire extinguisher located in garage. Isolation area for ill children is outside and away from other children. First aid kit is fully stocked with supplies. Home is equipped with a landline and Licensee has a cell phone. Per licensee there are no weapons or firearms in the home. LPA reviewed 5 children’s records and all required documents were in children’s files. Licensee was reminded to keep a file for assistants working with children. Licensee CPR/First Aid is current and will expire on 12/2023. Mandated Reporter is current and expires 03/2025. Licensee provides and cooks meal for children in care. Infant bottles are properly labeled with infant’s names. Children’s roster was reviewed and is up to date. Last emergency drill was documented on 06/21/2023. Licensee conducts monthly emergency drills. Licensee carries liability insurance via State Farm Insurance Company. LPA collected LIC9108, TB, and Immunzation records from Licensee. Cont. page 2...

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

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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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: GONZALES, REGINA LOUISE	FACILITY NUMBER: 414000845
	VISIT DATE: 06/27/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Where any IMS is provided a Plan for Providing IMS must be submitted to the Department. 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 publication: Commonly Asked Questions and Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

Safe Sleep

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resources.

Cont. page 3...

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

LIC809 (FAS) - (06/04)

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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: GONZALES, REGINA LOUISE	FACILITY NUMBER: 414000845
	VISIT DATE: 06/27/2023

NARRATIVE

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Licensee was reminded, As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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 tools, please send them by email 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/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

As of today, no deficiencies were issued under CCR, Title 22, Division 12.

Exit interview conducted and report was reviewed with the Licensee, Regina Gonzales.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

LIC809 (FAS) - (06/04)

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