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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001690
Report Date: 03/06/2025
Date Signed: 03/06/2025 11:43:55 AM

Document Has Been Signed on 03/06/2025 11:43 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:VARGAS, CLAUDIA PATRICIAFACILITY NUMBER:
414001690
ADMINISTRATOR/
DIRECTOR:		VARGAS, CLAUDIA P.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 846-2494
CITY:COLMASTATE: CAZIP CODE:
94014
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
03/06/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Claudia Patricia VargasTIME VISIT/
INSPECTION COMPLETED:
12:20 PM
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On March 6th, 2025, at approximately 9:00 AM, Licensing Program Analyst (LPA) Janet Gil conducted an unannounced, annual inspection. LPA met with licensee, Claudia Patricia Vargas, and explained the purpose of the inspection. Present during LPA’s visit included licensee, three assistants, and 9 enrolled children (3 infants and 6 preschoolers). The licensee is a large license and is operating within capacity limits and ratio.

Licensee owns home, which is a 5 bedrooms, 3 bathroom, multi level house. Licensee lives in home with spouse. All adults living and working in the home have fingerprint clearance. Facility operates Monday Through Friday 8:00 AM to 5:00 PM.

Day Care Areas: Ground floor of the home only that includes the kitchen, bedroom #1 (nap room), bedroom #2 (activity/nap room), living room, bathroom and backyard.

Off Limit Areas: Garage and entire second level of the home. Off limit areas have been made inaccessible with closed doors.

At approximately 9:30 AM, LPA toured day care areas of home with licensee. LPA observed the home to be in repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in working condition. LPA observed a fully stocked accessible first aid kit located in the kitchen area. LPA did not observe any accessible cleaning supplies, poisons, and solutions in day care areas. LPA observed electrical outlets to be made inaccessible with outlet covers and furniture. Home is equipped with a fully charged fire extinguisher in kitchen area. LPA observed kitchen cabinets to have child safety locks installed. LPA observed home to not have a working carbon monoxide detector. Type B deficiency is being issued on this day in accordance with the California Code of Regulations, Title 22, see LIC 809D. Licensee does not have any children in care with allergies or IMS plans. Per licensee, she provides all foods for the children in care.

At approximately 10:15 AM, LPA observed bathroom for children's use was in proper working condition. LPA observed bathroom to include appropriate toileting equipment and sanitation products. LPA did not observe any hazardous materials to be accessible to children in the bathroom.

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Garfield LeungTELEPHONE: (650) 266-8800
Janet GilTELEPHONE: 650-266-8800
DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: VARGAS, CLAUDIA PATRICIA
FACILITY NUMBER: 414001690
VISIT DATE: 03/06/2025
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The entire backyard is fully enclosed. The outdoor area is equipped with a variety of toys and materials. LPA observed a built in play structure with turf grass underneath. LPA did not observe any pools, spas, or bodies of water in day care areas.

LPA reviewed six children records which were complete. The children’s files have a record of emergency identification information and required immunization. LPA reviewed staff records for licensee and present staff which were not complete. Licensee's CPR/FIrst Aid is current and will expire 7/2025. The licensee’s Mandated Reporter training certification is also current and will expire 02/2027. The licensee also has required immunization available for review. During staff record review LPA observed two present staff to be missing Mandated Reporter training certification. Per licensee, staff is currently working on online certification. LPA issued a technical violation for missing Mandated Reporter Certification.

LPA observed licensee is not documenting infant safe sleep during nap times for her enrolled infants. A Type B deficiency is being issued on this day in accordance with the California Code of Regulations, Title 22, see LIC 809D.

Licensee has licensing documentation properly posted and available for review. The licensee also maintains a childcare roster that was made available for review. Emergency disaster drills are conducted at least once every six months. The last disaster drill was conducted on November 15th, 2024. Per licensee, there are no weapons or firearms in the home.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Janet GilTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: VARGAS, CLAUDIA PATRICIA
FACILITY NUMBER: 414001690
VISIT DATE: 03/06/2025
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When 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 about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

On this date, 3/5/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

During the exit interview, the licensee, Claudia Patricia Vargas, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Two Type B deficiencies are being issued on this day in accordance with the California Code of Regulations, Title 22, see LIC 809D.

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.

Exit interview conducted and report was reviewed with the licensee, Claudia Patricia Vargas.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Janet GilTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/06/2025 11:43 AM - 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: VARGAS, CLAUDIA PATRICIA
FACILITY NUMBER: 414001690

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in having one or more working carbon monoxide detectors in the facility which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/20/2025
Plan of Correction
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Licensee plans to purchase a new carbon monoxide alram, install it, then send a video to LPA Gil testing the dtector.
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in documenting infant safe sleep every 15 minutes which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/20/2025
Plan of Correction
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Licensee plans to have staff present in infant nap room document infant safe sleep every 15 minutes on provided sleep log, then send it to LPA Gil.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Garfield LeungTELEPHONE: (650) 266-8800
Janet GilTELEPHONE: 650-266-8800

DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2025

LIC809 (FAS) - (06/04)
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