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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
414004535
Report Date:
02/29/2024
Date Signed:
02/29/2024 04:44:15 PM
Document Has Been Signed on
02/29/2024 04:44 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:
JEFFEL, ISABEL
FACILITY NUMBER:
414004535
ADMINISTRATOR:
JEFFEL, ISABEL
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(650) 201-2496
CITY:
SOUTH SAN FRANCISCO
STATE:
CA
ZIP CODE:
94080
CAPACITY:
14
CENSUS:
12
DATE:
02/29/2024
TYPE OF VISIT:
POC
UNANNOUNCED
TIME BEGAN:
03:45 PM
MET WITH:
Isabel Jeffel, Nancy Santos
TIME COMPLETED:
04:55 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with facility representative and helper for this plan of correction visit established on 2/20/2024. Purpose of visit explained. There are 12 children present during the visit. The following previously cited deficiencies are observed to be corrected and cleared today:
Section 102416(c) - Pediatric First Aid and CPR. Licensee now has current Pediatric First Aid and CPR certification (exp 2/2026).
Section 102418 - Children now all have documentation of current immunizations on file.
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 provided and shall remain posted for 30 days.
SUPERVISOR'S NAME:
Daniel J Oquendo
TELEPHONE:
(650) 266-8800
LICENSING EVALUATOR NAME:
Andrea Medlin
TELEPHONE:
650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE:
02/29/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/29/2024
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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