414004768-1-25-2023-05-CC-CQUO-CNEUDT-20230125143002

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004768
Report Date: 01/25/2023
Date Signed: 01/25/2023 02:30:51 PM

Document Has Been Signed on 01/25/2023 02:30 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SANDINO, ADELA		FACILITY NUMBER:	414004768
ADMINISTRATOR:	SANDINO, ADELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 731-4737
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 7	CENSUS: 7	DATE:	01/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Adela Sandino		TIME COMPLETED:	02:45 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	On January 25, 2023 at approximately 11:30am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Adela Sandino, and explained the purpose of the visit. Present during LPA's visit included licensee, licensee's adult child/helper, and 7 enrolled children (3 infants and 4 preschool age). Licensee is operating within capacity limits and ratio during LPA's visit. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are 8:00am to 6:00pm. The home is a multi-level, single family home. The DAY CARE AREAS are located on the first level of the home, which includes the living room, kitchen, bathroom, backyard and family room (located on second floor). The OFF LIMIT AREAS are bedroom #1 (located on first level of the home), garage, and all bedrooms and bathrooms located on second level of the home. Off limit areas are made inaccessible with child safety gates and/or child safety handles. LPA inspected day care areas for health and safety hazards. LPA observed home to be in good repair with proper temperature and ventilation. Electrical outlets in day care areas are made inaccessible with child safety covers. There is a fire place in the home that is properly barricaded and made inaccessible to enrolled children. LPA observed a variety of age appropriate toys, materials and equipment inside and outside the home that were in good working condition. LPA observed cleaning supplies, poisons and other chemicals to be stored inaccessible to children behind child safety locked cabinets and/or in home's high shelves. The entire backyard is enclosed with an at least 5 ft. high fence. LPA did not observe any pools, spas or bodies of water on the property. (Continue Report on Page 2...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SANDINO, ADELA	FACILITY NUMBER: 414004768
	VISIT DATE: 01/25/2023

NARRATIVE

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Storage for children's belongings are located inside the home, labeled with each child's individual names. Cots are utilized for napping children with children's individual sheets that are sent home and laundered weekly.

LPA observed home is equipped with a fire alarm system, fully stocked first aid kit, multiple fully charged fire extinguishers, and multiple smoke/carbon monoxide detectors. There is a working phone on site. Phone number listed for licensee is current. Per licensee, there are no weapons or firearms in the home.

LPAs reviewed 7 children's records, whom were present during the inspection, which were complete. Children's files have a record of emergency identification information on file. LPA reviewed licensee's file which was also complete. Licensee has proof of required immunizations that were made available for review. Licensee's CPR/First Aid is current and will expire 07/2023. LPA observed licensing documentation to be properly posted and available for review in entrance of home.

During annual inspection, LPA discussed with licensee annual fee due, licensee's contact information, Mandated Reporter training renewal, capacity ratio and limits, and required documentation to maintain for all future staff to be hired.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: www.ada.gov/childqanda.htm.

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
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SANDINO, ADELA	FACILITY NUMBER: 414004768
	VISIT DATE: 01/25/2023

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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.

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

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, Adela Sandino.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

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