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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004674
Report Date: 07/15/2021
Date Signed: 07/15/2021 01:25:05 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:HERNANDEZ,MARILU V.FACILITY NUMBER:
414004674
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
07/15/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Marilu V. HernandezTIME COMPLETED:
10:55 AM
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On 7/15/21 at 9:45AM, Licensing Program Analyst (LPA) Tapia-Mandujano met with Licensee, Marilu V. Hernandez for an inspection to increase capacity. Licensee has requested to increase from a Small to a Large Family Child Care. Present is the home are licensee and 5 children (2 infants, 2 preschool, and one school age).
Licensee rents home, which is a 2 bedroom, 1 bathroom, single level house, with a converted garage. Daycare areas are: Living Room, Bedroom #2, Bathroom#1, Kitchen/Dining area, portion of the Front Yard, and Side Yard (adjacent to the Kitchen), and Backyard. OFF limit areas: Master Bedroom #1, portion of the front yard, and Storage. All off limit areas, including all closets, are properly barricaded. Hours of operation are Monday- Friday from 7am-5:30pm.
LPA inspected the home for Health and Safety Hazards. Home has multiple working smoke detectors, a carbon monoxide detector, a working telephone, and a fully charged Fire Extinguisher. First Aid Kit is fully stocked and accessible. All harmful and sharp objects are made inaccessible from children in care. Licensee states there are no guns or weapons in the home. The home is clean and orderly with sufficient lighting and ventilation. Licensee states she will conduct an emergency drill once every six months and log drills. Home has age appropriate toys and equipment available for the children in care. Licensee states discipline policy is redirection. Licensee's CPR certificates expires on 08/2021. Licensee's Mandated Reporter expires on 7/2023. Licensee is reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. Licensee has 2 dogs that are separated from daycare children. LPA explained and will email a copy of Tittle 22 regulations for capacity of a Small and Large Family Child Care Home.
This report is discussed and explained to the applicant. Records to be Maintain in the facility was previously explained to use for all children in care. Mandatory Posting Requirements: License, Emergency Disaster Plan, and Notification of Parents Rights Poster.
Prior to recommended for licensure, fire clearance needs to be granted by Redwood City FIre Department.
Copy of this report was emailed to the licensee. Signed copy of this report will be kept in the facility file and made available for public review. Desk Duty is available Monday through Friday between 8:00 AM - 5:00 PM at (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 350-2554
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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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