414004480-11-21-2023-05-CC-JTSE-CXT3JM-20231121171746

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004480
Report Date: 11/21/2023
Date Signed: 11/21/2023 05:18:38 PM

Document Has Been Signed on 11/21/2023 05:18 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:	VALDERRAMA, SUNSHINE		FACILITY NUMBER:	414004480
ADMINISTRATOR:	VALDERRAMA, SUNSHINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 699-6712
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	14	CENSUS: 12	DATE:	11/21/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Licensee, Sunshine Valderrama		TIME COMPLETED:	05:15 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 11/21/2023, at approximately 3:00PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit. LPA was granted entry to the facility by Licensee, Sunshine Valderrama. LPA explained the purpose of the visit. Present during the visit were the Licensee, Licensee’s husband, two assistants, nine preschool age children, and 3 infants. The facility is in compliance with capacity requirements. All adults living and working in the home have fingerprint clearance and are associated to the facility. The facility’s operating hours are 7:30AM to 5:30PM. The home is a one level, two bedroom, three bathroom home. Daycare Areas: Main Classroom, Bedroom 2 (used as infant classroom), Bathroom 1, Bathroom 2 (located in infant classroom), and backyard. Off-limits Areas: Bedroom 1, Bathroom 3 (located in Bedroom 1), Living Room, Kitchen, Dining Room, Shack (located in Backyard) and Garage. LPA inspected the home for any health and safety hazards. The home is kept in clean and orderly condition. There are age-appropriate toys, equipment, and learning materials for children in care. The home is equipped with a fully charged fire extinguisher. There are two combination smoke and carbon monoxide detectors that were demonstrated to be operational. LPA observed all cabinets, drawers and other storage areas that are accessible to children to be equipped with childproof locks. Off-limits areas are sufficiently barricaded to be inaccessible to children. LPA observed the first aid kit to be properly stocked with materials necessary for the administration of first aid. There are four infant cribs located in the infant classroom that arefree of loose articles. The home does not have a fireplace. Continued on Page Two

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: VALDERRAMA, SUNSHINE	FACILITY NUMBER: 414004480
	VISIT DATE: 11/21/2023

NARRATIVE

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The backyard was observed to be equipped with age-appropriate toys and equipment that are in good repair. There is sufficient cushioning in the form of artificial turf for children to play on. The backyard is enclosed with fences that are at least five feet high. The off-limits Shack is secured and locked. There are no pools or other bodies of water located in the facility. Licensee has a dog present in the facility. LPA and Licensee discussed maintaining communication with parents about the presence of a pet.

LPA reviewed Licensee’s file, two Assistant’s files and six children’s files. Upon review, LPA observed that all children’s files were complete, and included sleep logs for all children were enrolled as infants. Licensee’s file was observed to be complete. Licensee’s First Aid/CPR training expires on 10/2025, and Mandated Reporter Training expires on 2/2025. Emergeny drills are conducted every six months and are properly documented. The last drill was conducted in July.

Licensee prepares breakfast, lunch, and morning/afternoon snack for children. Ill children are to be isolated in the entryway .Per Licensee, there are no firearms or weapons 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: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: VALDERRAMA, SUNSHINE	FACILITY NUMBER: 414004480
	VISIT DATE: 11/21/2023

NARRATIVE

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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-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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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

No deficiencies were cited during today’s visit.

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

Exit interview conducted and report was reviewed with the licensee, Sunshine Valderrama.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

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