414004612-8-15-2022-05-CC-SLOO-CHBUJF-20220815153728

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004612
Report Date: 08/15/2022
Date Signed: 08/15/2022 03:37:58 PM

Document Has Been Signed on 08/15/2022 03:37 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PICAZO, NATALIE AGUILAR		FACILITY NUMBER:	414004612
ADMINISTRATOR:	PICAZO, NATALIE AGUILAR		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 889-0160
CITY:	BRISBANE	STATE: CA	ZIP CODE:	94005
CAPACITY:	14	CENSUS: 7	DATE:	08/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:54 PM
MET WITH:	Natalie Picazo		TIME COMPLETED:	03:25 PM

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On August 15, 2022, Licensing Program Analyst (LPA) Sheran Lo arrived at the facility to conduct an unannounced Annual Inspection and met with the Licensee Natalie Picazo. Purpose of the inspection was explained. Present there were Licensee, two helpers and seven preschool age children in care. Per Licensee, the duplex unit is owned and living at home are Licensee, husband, daughter, and newborn. LPA verified the background check clearance of the adults working or living in the home. The hours of operation are: M-F, 8:00 AM – 5:00 PM. Licensee provides snacks and children bring their own lunch each day.

Daycare areas: Living Room, Dining Room, Bathroom, and Backyard. Off Limit areas: Unit B, Bedroom, and Kitchen. LPA and Licensee inspected the entire day care area for Health and Safety hazards. LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care. All cleaning supplies were locked away inaccessible to children. There was a separate carbon monoxide and smoke detector in the home. LPA performed the tests to check the functionality of the detector. A fire extinguisher of size 2A10BC or bigger was also available in the home. First Aid kit is fully stocked and accessible. Per Licensee, there are no firearms or weapons in the home. Licensee states, there are no bodies of water or pets.

LPA observed that the house is in good repair and free of hazards with proper temperature and ventilation. LPA observed that there is a variety of age appropriate toys, books and other learning material available in the home for the children in care. Electric outlets have been secured with child protective covers, and a working phone is on site. Per Licensee, Discipline policy is redirection or communicate about positive behavior practices.

All posting requirements are met and posted near the day care entrance. Licensee has First Aid CPR that expires 6/23. LPA observed that files have records of immunization, names, addresses and telephone numbers of each child's authorized representative.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran Lo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PICAZO, NATALIE AGUILAR	FACILITY NUMBER: 414004612
	VISIT DATE: 08/15/2022

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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/inspection-process.

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.

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-and-resources/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.

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.

Exit interview conducted and report was reviewed with the licensee Natalie Picazo.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran Lo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

LIC809 (FAS) - (06/04)

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