414004665-2-4-2022-05-CC-AMEN-CBBVUT-20220204154517

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004665
Report Date: 02/04/2022
Date Signed: 02/04/2022 03:45:21 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:	QUINTERO, ROSALBA		FACILITY NUMBER:	414004665
ADMINISTRATOR:	QUINTERO, ROSALBA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 568-0499
CITY:	SO. SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	14	CENSUS: 6	DATE:	02/04/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Rosalba Quintero, America Canchola		TIME COMPLETED:	03:55 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 facility representative for this required annual visit today. Purpose of visit explained. There are 6 children present during the visit; 2 infants and 4 preschool aged. Days and hours of operation: Monday-Friday 6:00AM--5:00PM. Licensee states she, one adult daughter, and one minor child reside in the home; criminal record clearance is on file for all adults. Licensee reminded once a person turns 18 years old, and if living or working in the home, criminal record clearance is required. Physical plant toured to inspect for health and safety hazards. The home has smoke detectors, fully charged fire extinguishers, and a carbon monoxide (CO) detector. Outdoor space inspected for health and safety hazards; outdoor play area is completely fenced. The daycare areas used are: living room//family room converted into daycare use, one bathroom, one bedroom (minor daughters room) may be used for daycare children to nap only; and outside backyard designated areas. The sandbox must either be covered or checked daily before children's use to remove any hazardous items. First aid supplies are available. Detergents, cleaning compounds, medications, and other items which could pose a danger to children is stored inaccessible to children. The daycare areas are kept clean and orderly and has adequate heating and ventilation for safety and comfort. Per Licensee, there are no pets and 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. Licensee has current Pediatric First Aid and CPR certification (exp 10/2023); the required staff immunizations: measels (MMR) and pertussis (Tdap); and has verification of the mandated child abuse reporting requirement training (exp 8/7/2023) as compliant with AB1207. All the required licensing forms are centrally posted. 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. (Continued on next page 809-C)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022

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: QUINTERO, ROSALBA	FACILITY NUMBER: 414004665
	VISIT DATE: 02/04/2022

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.

This report is reviewed with facility representative 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 Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022

LIC809 (FAS) - (06/04)

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