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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004575
Report Date: 03/28/2024
Date Signed: 03/28/2024 11:33:44 AM


Document Has Been Signed on 03/28/2024 11:33 AM - 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:ESPINOZA, YADIRAFACILITY NUMBER:
414004575
ADMINISTRATOR:ESPINOZA, YADIRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 315-4277
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:14CENSUS: 5DATE:
03/28/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Yadira EspinozaTIME COMPLETED:
12:00 PM
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On March 28th, 2024, at approximately 9:00 AM, Licensing Program Analyst (LPA) Janet Gil conducted an unannounced, annual inspection. LPA met with licensee, Yadira Espinoza, and explained the purpose of the inspection. Present during LPA’s visit included licensee, assistant, minor child, and 5 enrolled children (2 infants and 3 preschoolers). The licensee is a large license and is operating within capacity limits and ratio. Licensee lives with her spouse and two minor children. All adults living in the home have fingerprint clearance on file. The hours of operation are Monday through Friday 8:30 AM to 5:00 PM.

Licensee rents the home with spouse. The home is a multi-level, family home. All day care areas are located on the main level of the home.

Day Care Areas: living room, dining room, sun room, bathroom #1, front yard and upper level of backyard area.


Off Limit Areas: all bedrooms on main level, bathroom #2, bathroom #3, side yard (pass through only), lower backyard, kitchen, garage and entire lower level of the home. Off limit areas are barricaded with locked doors and gates.
At approximately 10:00 AM, LPA toured day care areas of home with licensee. LPA observed the home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good working condition. LPA observed a fully stocked accessible first aid kit. LPA did not observe any accessible cleaning supplies, poisons, and solutions in day care areas. LPA observed a fireplace in dining room area that was properly barricaded and made inaccessible to children in care. LPA observed electrical outlets to be made inaccessible with furniture. Home is equipped with a fully charged fire extinguisher and multiple carbon monoxide detectors. The licensee also has a fire alarm by the dining room entrance area. LPA tested carbon monoxide detector next to front door, which was observed to be working. Safety locks are installed in all cabinets of the main day care room. Licensee does not have any children in care with allergies or IMS plans. Per licensee, she provides food for half the children in her care and that are not vegetarians.

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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Janet GilTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2024
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: ESPINOZA, YADIRA
FACILITY NUMBER: 414004575
VISIT DATE: 03/28/2024
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At approximately 10:30 AM, LPA observed bathroom for children's use was in proper working condition. LPA observed bathroom to include appropriate toileting equipment and sanitation products. Per licensee, she has no children in care that use the bathroom. LPA did not observe any hazardous materials to be accessible to children in the bathroom.

The entire front yard and backyard is fully enclosed. The outdoor area is equipped with a variety of toys and materials. LPA did not observe pools, spas or bodies of water. Per licensee, they are not using the backyard at this time but it is a Day Care area and she plans to use it later on when there is less windy weather in area.

LPA reviewed five children records which were complete. The children’s files have a record of emergency identification information and required immunization. LPA reviewed staff records for licensee and present assistant which were complete. Licensee's CPR/FIrst Aid is current and will expire 11/2024. The licensee’s Mandated Reporter training certification is also current and will expire 09/11/2025. The licensee also has required immunization available for review. LPA also observed assistant to have current CPR and Mandated Reporter training certification that will expire 3/2026.

Licensee has licensing documentation properly posted and available for review. The licensee also maintains a childcare roster that was made available for review. Emergency disaster drills are conducted at least once every six months. The last disaster drill was conducted in January 9th, 2024. Per licensee, there are no weapons or firearms 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: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Janet GilTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
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: ESPINOZA, YADIRA
FACILITY NUMBER: 414004575
VISIT DATE: 03/28/2024
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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 childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

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

Exit interview conducted and report was reviewed with the licensee, Yadira Espinoza.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Janet GilTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
LIC809 (FAS) - (06/04)
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