414004519-6-1-2023-05-CC-MOLN-CSDTRU-20230601145807

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004519
Report Date: 06/01/2023
Date Signed: 06/01/2023 02:59:30 PM

Document Has Been Signed on 06/01/2023 02:59 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:	LOPEZ, OLGA E.		FACILITY NUMBER:	414004519
ADMINISTRATOR:	LOPEZ, OLGA E.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 690-4430
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	14	CENSUS: 7	DATE:	06/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:51 PM
MET WITH:	Wendy Ventura		TIME COMPLETED:	03:20 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 June 1, 2023. Licensing Program Analyst (LPA) Maria Olguin-Leon met with helper Wendy Ventura for an unannounced annual inspection. Licensee, Olga Lopez arrived at home at 2:25 PM from picking up children from school. The purpose of the inspection was explained. Present today is both Licensee, 1 helper and 9 children (1 infant, 6 preschoolers, & 2 school age children). Licensee is operating within capacity and ratio requirements on this day. Licensee and helper have criminal record clearances on file with the department. Hours of operation are Monday– Friday, 7:30am to 5:30pm. LPA and Licensee toured the home for health and safety hazards. The home is a two--story home. Day Care Areas: Living room, bathroom, kitchen, and backyard. Off Limits Areas: Entire second floor. Kitchen is barricaded with child proof gate. The home is clean and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. There are plenty of age-appropriate toys, child size furnishings, learning material and play pens. Backyard play area has plenty of outdoor toys in good repair and fenced off with a 5 ft. fence. No spas, pool or other bodies of waters were observed. The home is equipped with a carbon monoxide detector, smoke detector and a fully charged fire extinguisher located in kitchen. Isolation area for ill children is in living room away from other children. First aid kit is fully stocked with supplies. Home is equipped with a cell phone. Per licensee there are no weapons or firearms in the home. LPA reviewed 5 children’s records, child #3 is missing emergency and medical consent form, Licensee will have parent resubmit. Helper CPR/First Aid expires 02/2025. Licensee CPR/First Aid is current and will expire on 02/2025. Licensee provides and cooks meal for children in care. One child brings their own lunch due to parent preference. Children’s roster was reviewed and is up to date. Last emergency drill was documented on 04/19/2023 and conducted monthly. Licensee carries liability insurance through DCI Insurance. 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: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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: LOPEZ, OLGA E.	FACILITY NUMBER: 414004519
	VISIT DATE: 06/01/2023

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.

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. 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.

Safe Sleep

LPA discussed the safe sleep regulations with licensee Olga Lopez 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.

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: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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: LOPEZ, OLGA E.	FACILITY NUMBER: 414004519
	VISIT DATE: 06/01/2023

NARRATIVE

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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, based on observation and file reviews, facility is currently in substantial compliance with title 22.

Exit interview conducted and report was reviewed with the licensee, Olga Lopez.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

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