<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002496
Report Date: 10/22/2024
Date Signed: 10/22/2024 02:34:39 PM


Document Has Been Signed on 10/22/2024 02:34 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:ANDINO, MARIA ISABELFACILITY NUMBER:
414002496
ADMINISTRATOR:ANDINO, MARIA ISABELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 298-8395
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY:14CENSUS: 8DATE:
10/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee, Maria Isabel AndinoTIME COMPLETED:
03:00 PM
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 October 22nd,2024 at approximately 9:30 am, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced annual/random inspection. Upon arrival, Assistant (A1) was present supervising 8 children (4 infants and 4 preschoolers). At approximately 9:45am, Licensee arrived at the facility. LPA met with Licensee, Maria Isabel Andino and explained the purpose of the inspection. All adults present today have fingerprint clearance and are associated.

Licensee rents home, which is a 2 bedroom, 2 bathroom, 2 level house. Licensee lives with husband and two adult children. The hours of operation are Monday-Friday from 7am-5pm. Daycare areas are: First floor: Play area, Bathroom#1, Dining area, Living room, and Backyard. Off Limit areas are: FirstFloor: Laundry room, closet/Computer room, Kitchen, and entire second floor: Bedroom #1 & #2, and Bathroom #2. All off limit areas, including closets, are properly barricaded.



LPA observed home to be clean and in good repair with proper temperature and ventilation. There were a variety of age appropriate toys and equipment in the home which were in good condition. Home does not have a fireplace. There is a pet cat that is separate from children in care with proper documentation. There were no pools, spas or bodies of water on the property. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Discipline Policy was discussed. Isolation Area for sick children is the hallway or living room.

There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed for Licensee will be updated in the system.Per Licensee, there are no weapons or firearms in the home. Infant children are sleeping in cribs or pack and plays in the living room. Licensee was unable to show LPA that sleep logs are maintained. Type B citation was issued.


Continued on Page 2...
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2024
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 6


Document Has Been Signed on 10/22/2024 02:34 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: ANDINO, MARIA ISABEL
FACILITY NUMBER: 414002496

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and interview, the licensee did not comply with the section cited above as upon arrival of LPA, assistant was supervising 8 children (4 infants and 4 preschoolers) without an additional assistant making the facility be over capacity which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/23/2024
Plan of Correction
1
2
3
4
Licensee arrived about 15 minutes later making the capacity back in compliance.

LPA explained the capacity regulations with and without an assistant. LPA provided capacity worksheet to licensee.

Licensee agrees to have the appropriate children allowed when there is only one person present and will ensure there is coverage at all times to maintain within capacity limits. Licensee will submit a written statement that she understands she cannot be overcapacity.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6


Document Has Been Signed on 10/22/2024 02:34 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: ANDINO, MARIA ISABEL
FACILITY NUMBER: 414002496

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as she is not maintaining the safe sleep logs for children under 24 months which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2024
Plan of Correction
1
2
3
4
LPA explained the requirement of safe sleep logs to licensee and printed safe sleep PIN for licensee with a sample of how to log when children sleep.

Licensee agrees to maintain the safe sleep logs and will send proof of Sleep logs being done for the rest of the week. Documentation of sleep logs will be emailed to LPA Tapia-Mandujano by 10/25/24.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6


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: ANDINO, MARIA ISABEL
FACILITY NUMBER: 414002496
VISIT DATE: 10/22/2024
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
26
27
28
29
30
31
32
Page 2 continued...

LPA reviewed the 8 children's file and facility files. Both children files and facility files are complete. Licensees CPR & First Aid Certificate expires on 09/2026. Licensee's Mandated Reporter Certificate has since expired. Technical Violation was issued. Last Emergency drill was 08/2024. Licensee is conducting Emergency Drills at least once every six months and properly logging the drills. All the required posting documentation, such as the facility license, Notification of Parental Rights have been placed in a prominent area for parents or representatives to review.

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 atwww.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Licensee was reminded that all adults 18 and over, 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 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.

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 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.



Continued on Page 3...
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: ANDINO, MARIA ISABEL
FACILITY NUMBER: 414002496
VISIT DATE: 10/22/2024
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
26
27
28
29
30
31
32
Page 3 Continued...

Incidental Medical Services (IMS) policy was discussed. Licensee does not offer IMS at this time. 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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee, Maria Isabel Andino, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 10/22/24.

***California Code of Regulations, (Title 22, Div. 12, Ch 3) were cited on this day.



Three type “A” violations were issued today. Licensee is advised to provide a copy of the Evaluation Report and all Type “A” Deficiencies cited, to the parents and guardians of children currently enrolled in care and to parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files. Notice of site Visit will be posted and should remain posted for 30 days, failure to post will result in an immediate civil penalty.

Exit interview conducted and report was reviewed with the licensee, Maria Isabel Andino.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6