<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004705
Report Date: 08/26/2021
Date Signed: 08/26/2021 01:10:04 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:PELAEZ, SILVIAFACILITY NUMBER:
414004705
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
08/26/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Silvia PelaezTIME COMPLETED:
11:10 AM
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's (LPA) Tapia-Mandujano conducted an unannounced inspection for increase of capacity today and met with licensee, Silvia Pelaez for her request to increase from a Small to a Large Family Child Care. Fire Clearance has been granted by Redwood City Fire Department on 8/16/21. Present in the home are licensee, licensee's husband, licensee's adult son, and three infant children.

Licensee owns home, which is a 3 bedroom, 2 bathroom, single level (front) Duplex. Hours of operation are Monday-Friday from 8AM-5PM. Daycare area is: Living Room, Bedrooms #1, #2, and #3, Dining area, Family Room/Playroom, Bathroom#1 & 2, backyard, and Side yard. OFF limit areas: Front yard, Kitchen, and Garage. All off limit areas are properly barricaded and inaccessible for children. LPA inspected entire home for Health and Safety Hazards.

LPA observed home to be clean and in good repair with proper temperature and ventilation. There is a variety of age appropriate toys and equipment in the home which are in good condition. There are no pools, spas, or bodies of water on the property. Home has a fireplace that is properly barricaded. Backyard and Side yard is fenced and properly barricaded leading to off limit areas. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children. There is a fully charged fire extinguisher, and a working telephone. Per Licensee, there are no weapons or firearms in the home. Licensee has 2 dog pets that are kept separately from daycare children. Licensee's CPR & First Aid expires on 6/2022. Licensee's Mandated Reporter certificate expires on 7/2022. Per licensee there are two dogs in the home that are kept separate from children.Postings were posted near main door. 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.

Prior for approval of a Large Family Child Care Home License, the following must be completed:
*Video of functional smoke alarm and carbon monoxide alarm

This report will be emailed to the Applicant. A signed copy will be kept on file. This report must be available in the facility for public review. Any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: 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: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1