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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414003086
Report Date: 10/11/2024
Date Signed: 10/30/2024 08:38:18 PM

Document Has Been Signed on 10/30/2024 08:38 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:TRAN, ANDY N.FACILITY NUMBER:
414003086
ADMINISTRATOR/
DIRECTOR:		TRAN, ANDY N.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 281-1556
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94062
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 10DATE:
10/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:51 AM
MET WITH:Andy TranTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On September 11,2024, at approximately 8:50pm, Licensing Program Analysts (LPAs) Maria Olguin-Leon and Melissa Zaragoza conducted an unannounced annual inspection in conjunction with a case management inspection. LPAs met with licensee Andy Tran, and purpose of inspection was explained. Licensee requested an update to licensee to add a room to daycare. Present during today’s visit was Licensee, 2 helpers and 10 children (4 infant and 6 preschool age children). Facility is operating within capacity and ratio requirements on this day. All adults present in home have criminal background clearances. Childcare hours of operation are Monday - Friday from 8:00am to 5:30pm.

LPAs and licensee toured the indoors and outdoors of the daycare areas for health and safety hazards. Main home is a two-level story home and there is a separate building (recreation room) used for the main daycare. Licensee requested to add bedroom #3 in main home to daycare area. Room is located on 1st level of home. LPAs inspected room for health and safety hazards. As of today, fire inspection clearance has not been received in regional office. Day Care Area: Detached recreation room (main daycare room) and backyard. Off Limits Areas: The entire main home. Bedroom #3 will be approved once fire inspection clearance approval has been received. Isolation area for sick children is an area outdoors and away from other children. Off limits cabinets are equipped with childproof lock or empty. LPAs observed daycare area to be clean and orderly. Daycare is well light and has proper ventilation. LPA observed electrical outlets are secured with child proof covers and inaccessible to children. Storage cubbies are available for children to store personal belongings. LPAs observed a refrigerator, air fryer and toaster on kitchen area counter. Per Licensee, main home kitchen is occasionally used for cooking food. There are plenty of age-appropriate toys, books, child size furnishings, learning material, sleeping cots and a crib in bedroom #3. LPAs observed a bathroom to be clean and have children’s toiletries. There is a changing table located outside bathroom. Backyard patio area is equipped with plenty of age-appropriate toys which include, slide/climbing structure, ride on toys, swings hanging from deck gazebo beam and play kitchen, all in good condition. Patio is equipped with a gazebo to provide shade for children’s care. Patio is cement flooring and play structure is equipped with sand to cushion falls. LPAs did not observe any spas, pools, or other bodies of water. Entire backyard is surrounded with a 5 ft. fence and a off limits backyard is equipped with a wire fence barrier.

Cont. page 2...
Marie RodriguezTELEPHONE: (650) 266-8800
Maria Olguin-LeonTELEPHONE: 650-266-8800
DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2024
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: TRAN, ANDY N.
FACILITY NUMBER: 414003086
VISIT DATE: 10/11/2024
NARRATIVE
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Daycare room is equipped with a working dual carbon monoxide/smoke detector. LPA observed a fully charged fire extinguisher hanging in daycare room. LPAs reviewed first aid kit and kit is fully stocked. Licensee maintains a cell phone on the premise. Per licensee, there are no weapons or firearms in the home. Parents provide sheets for sleeping cots and are sent home on a weekly for laundering.

LPA reviewed 5 children’s files and 3 staff files. All files were complete with all required documents. LPAs reviewed sleep logs; LPAs reminded Licensee to continue maintaining sleep logs for infant child in care. Licensee maintains an updated Children’s roster. Licensee CPR/FA expiration date is 2/2026. Licensee Mandated Reporter training expires 06/2026. Licensee provides meals to children in care, which includes snack, lunch, and dinner. LPA reminded licensee any food brought from home must be labeled and stored properly. LPAs observed Childcare License, Emergency Disaster Plan (LIC610A) and Parent's rights posted. Last emergency drill was conducted on 03/27/2024, facility is overdue for an emergency drill, technical violation provided. Licensee carries liability insurance via Acord effective 02/28/2024.

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.

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/.

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's reviewed AB 1207 with the Licensee.


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SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
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: TRAN, ANDY N.
FACILITY NUMBER: 414003086
VISIT DATE: 10/11/2024
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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

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. LPAs also informed licensees 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.

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

During the exit interview, the LICENSEE, Andy Tran confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.



No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. LPAs will approve room addition upon receipt of fire inspection clearance.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Andy Tran.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4