<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004535
Report Date: 02/26/2020
Date Signed: 02/26/2020 05:08:04 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:GARCIA, MARIA ISABELFACILITY NUMBER:
414004535
ADMINISTRATOR:GARCIA, MARIA ISABELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 873-4204
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:14CENSUS: 11DATE:
02/26/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Maria Garcia, Maria Vega De Gomez TIME COMPLETED:
05:10 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
Licensing Program Analyst (LPA) Andrea Medlin met with staff helper, and later Licensee arrived, for this annual licensing visit. Staff helper left alone with 11 children until Licensee arrived. Days and hours of operation: Monday-Friday 7:00AM-5:00PM. There are 11 children present during the visit; 3 infants, 6 preschool, and 2 school aged. Licensee states that she, husband, and adult son reside in the home; criminal record clearance is on file for all adults in the home. Physical plant toured to inspect for health and safety hazards in the licensed areas. Outdoor space inspected for health and safety hazards; outdoor play area is completely fenced. The home has a fully charged fire extinguisher and a carbon monoxide (CO) detector, however upon arrival there was no smoke detector; Licensee had retrived it and replaced batteries installed and is operating now. First aid supplies are available. Detergents, cleaning compounds, medications, and other items which could pose a danger to children is stored inaccessible to children. Per Licensee, there are no firearms or weapons in the home. No spas, swimming pools, hot tubs, fish ponds, or similar bodies of water are present. Variety of age appropriate toys and materials is observed in the daycare. A sick child would be separated from the group and wait for parent to pick up. Licensee has current Pediatric First Aid and CPR training (exp.3/2020). Staff helper who was alone with children upon arrival does not have First Aid and CPR certification. Staff and children's files reviewed.

Due to many observed violations and time constraints, this visit will be continued at another time to document all violations seen today.

This report is reviewed with Licensee and a copy of this report must be made available for public review upon request. Notice of site visit posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
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 1