414002671-4-19-2023-05-CC-MOLN-CR2R3Y-20230419124044

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002671
Report Date: 04/19/2023
Date Signed: 04/19/2023 12:42:00 PM

Document Has Been Signed on 04/19/2023 12:42 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:	RODRIGUEZ, SOLEDAD C. & RODRIGUEZ, MAGALY		FACILITY NUMBER:	414002671
ADMINISTRATOR:	RODRIGUEZ, SOLEDAD C.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 483-5583
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	14	CENSUS: 0	DATE:	04/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Soledad Rodriguez		TIME COMPLETED:	01:00 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 April 19, 2023, Licensing Program Analyst (LPA) Maria Olguin-Leon met with licensee, Soledad Rodriquez for an unannounced annual inspection. The purpose of the inspection was explained. Present for today’s visit was Licensee and no children. Licensee operates Mon-Fri. 8:00-5:00 PM. LPA and Licensee toured the home to conduct a Health and Safety Inspection. The home is a single level home. The home is in good repair and free of hazards and has proper heating and ventilation. Daycare areas are: Living room, Bedroom #1 and Bedroom #3, napping room is currently not being used. Off limits areas: Bedroom #2, Both Bathroom, Kitchen, dining room. Backyard is off limits. Front yard is fenced and has plenty of toys and is cushioned with grass. Home is equipped with plenty of age-appropriate toys, playpens and learning materials all in good repair. There are no pools or bodies of water. Per licensee there are no weapons in the home. Fireplace in living room is properly barricaded with wall separator, which also barricades access to dining room and kitchen. The home is equipped at fully charged fire extinguisher (located in kitchen), a dual working carbon monoxide detector/smoke detector. All cleaning supplies and toxins are properly stored behind locked cabinets and inaccessible to children. Last emergency drill was conducted on February, 2023. CPR/First Aid is current until 07/2023. Mandated reporter expired, Licensee will complete and submit to LPA. First aid kit is available and equipped with necessary supplies. Isolation area will be in living room on sofa. LPA reviewed 2 children’s records. All the children's records were complete. The home has all necessary paperwork posted. Licensee was given a copy of LIC126. Children bring their own meals from home and Licensee stores meals in refrigerator and are properly labeled with children's names. As per licensee, there is no firearm or weapon in the house LPA also informed the 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. 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: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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: RODRIGUEZ, SOLEDAD C. & RODRIGUEZ, MAGALY	FACILITY NUMBER: 414002671
	VISIT DATE: 04/19/2023

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.

Licensee was reminded 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 for influenza, pertussis and measles or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 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.

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: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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: RODRIGUEZ, SOLEDAD C. & RODRIGUEZ, MAGALY	FACILITY NUMBER: 414002671
	VISIT DATE: 04/19/2023

NARRATIVE

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Safe Sleep
LPA discussed the safe sleep regulations with licensee and discuss Soledad Rodriquez 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.

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.

Exit interview conducted and report was reviewed with the license, Soledad Rodriquez.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC809 (FAS) - (06/04)

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