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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002694
Report Date: 06/28/2023
Date Signed: 06/28/2023 12:23:39 PM


Document Has Been Signed on 06/28/2023 12:23 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:VASQUEZ, DEBORAHFACILITY NUMBER:
414002694
ADMINISTRATOR:VASQUEZ, DEBORAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 544-4852
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94062
CAPACITY:14CENSUS: 2DATE:
06/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Deborah VasquezTIME COMPLETED:
12:40 PM
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On June 28, 2023, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Deborah Vasquez for an unannounced annual inspection. The purpose of the inspection was explained. Present today was Licensee, Licensee ‘spouse, daughter and 2 infants. All adults have criminal record clearances on file with the department. Licensee is operating within capacity and ratio requirements on this day. Hours of operation are Monday– Friday, 8:00am to 5:30pm.

LPA and Licensee toured the home for health and safety hazards. Licensee owns this two story 4-bedroom home. Day Care Areas: Family room, bathroom #1, detached playroom & playroom bathroom and backyard. Family room is equipped with a child proof gate to barricade from other parts of the home. Off Limits Areas: The rest of the home. Bathroom in playroom is equipped with a child proof gate. All cabinets are properly secured with child proof latches. Daycare areas are well light and have proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. There are plenty of age-appropriate toys, books, child size furnishings, learning material and play pens. Backyard has plenty of age-appropriate play toys, there is an artificial grass area surrounded with a 3 ft fence. The rest of backyard is a paved with pavers and equipped with sunshades There is a chicken coop located in back right-side corner of yard. There are no spas, pools or other bodies of water. Backyard is completely fenced off with a 4 ft. fence.

The family room and playroom are equipped with a working dual carbon monoxide/smoke detector. Playroom and family are equipped with a fully charged fire extinguisher. Isolation area for ill children will be in playroom or 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 on the premises. Per licensee there are no weapons or firearms in the home. Licensee provides sheets for sleeping cots and playpens and are washed weekly or when soiled.

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SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2023
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 3


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: VASQUEZ, DEBORAH
FACILITY NUMBER: 414002694
VISIT DATE: 06/28/2023
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LPA reviewed 5 children’s records and all required documents were in children’s files and included LIC9227. Licensee Mandated Reporter training is current and expires 06/2025. Licensee’s CPR/First Aid is current and will expire on 11/2023. Licensee provides breakfast, lunch and afternoon snacks to children in care. Children’s roster was reviewed and is up to date. Last emergency drill was conducted on 05/03/2023 and is properly documented. All licensing documents are properly posted. Licensee carries childcare liability insurance via DCI insurance. Sleeping logs were observed and are properly logged. LPA collected Licensee’s immunization record and tax bill.

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. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com.

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SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
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: VASQUEZ, DEBORAH
FACILITY NUMBER: 414002694
VISIT DATE: 06/28/2023
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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. LPA discussed sleep sacks with Licensee.

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, Deborah Vasquez.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
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