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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213004686
Report Date: 04/16/2025
Date Signed: 04/16/2025 04:25:59 PM

Document Has Been Signed on 04/16/2025 04:25 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SAN GERONIMO VALLEY COMMUNITY CENTER CHILD CAREFACILITY NUMBER:
213004686
ADMINISTRATOR/
DIRECTOR:		NICOLE RAMIREZFACILITY TYPE:
840
ADDRESS:6350 SIR FRANCIS DRAKE BLVD.TELEPHONE:
(415) 488-8888
CITY:SAN GERONIMOSTATE: CAZIP CODE:
94963
CAPACITY: 52TOTAL ENROLLED CHILDREN: 23CENSUS: 8DATE:
04/16/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:34 PM
MET WITH:Nicole RamirezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On April 16, 2025, Licensing Program Analysts (LPAs) Van and Naves conducted an unannounced annual inspection and met with the Director, Nicole Ramirez. The purpose of the inspection was explained, and access to the center was granted. This facility is a school-aged after-school program. The center is currently approved to use room #7 and the multipurpose room. The director and two teachers supervised eight school-aged children.

Days and operating hours are Monday from 12:00 pm to 5:30 pm. The facility utilizes an electronic sign-in and sign-out system called MyRec; staff members will pick up children from their classrooms and safely escort them to the program. Upon returning to the center, the center’s staff will check them in and count everyone to ensure that all children are accounted for and safe.

All staff members present during the inspection had their criminal record clearances verified through the CDSS Guardian Background Check site and were found to have eligible clearance status.

Director and LPAs inspected the facility for potential health and safety hazards. The classrooms have age-appropriate games, books, and well-maintained learning materials. The room provides adequate ventilation and ample lighting. The facility has a centralized smoke and carbon monoxide detector and a fully charged fire extinguisher. The director stated the center currently has no children with any medications. However, if or when families provide medications for their children, all medications will be stored in a locked cabinet inaccessible to children.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SAN GERONIMO VALLEY COMMUNITY CENTER CHILD CARE
FACILITY NUMBER: 213004686
VISIT DATE: 04/16/2025
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The facility has no pools or spas; however, there is a small creek that children must cross via a bridge in order to reach the multi-purpose classroom. All cleaning solutions, poisons, and other dangerous chemicals are inaccessible to children. All bathrooms, toilets, and sinks are clean and well-sanitized. All solid waste bins have suitable, tight-fitted lids.

The outdoor playground area is in good repair and completely fenced for supervision. LPAs observed that outdoor areas and age-appropriate play structures are free from health and safety hazards. The outdoor area has shaded areas for the children to rest, with a garden. A variety of toys and carts are available for the children to ride on.

LPAs reviewed the records of five children and five staff members. The center maintained complete records for the children, including authorized representatives' names, addresses, and phone numbers. Staff members' records indicated that all individuals requiring caregiver background checks had undergone criminal record checks and child abuse index clearances or exemptions. Several teachers held valid CPR certificates. However, it was noted that several staff members did have up-to-date mandated reporter training certificates, and two out of five staff members lacked their measles and influenza vaccinations.

LPAs reminded the director to post the required postings, including Waivers, Notification of Parents' Rights, and Notification of Personal Rights. LPAs provided the list of posting needed to the Director.



The Director stated that Fire and Earthquake drills were conducted monthly, typically with the elementary school. The last drill was completed on 3/20/2025.

The Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2025
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SAN GERONIMO VALLEY COMMUNITY CENTER CHILD CARE
FACILITY NUMBER: 213004686
VISIT DATE: 04/16/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Director was informed about Mandated Reporter training AB 1207. The Mandated Reporter AB 1207 training must be completed every two years by the Licensee and for all staff hired. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The Director was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES.

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.



Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5 years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2025
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SAN GERONIMO VALLEY COMMUNITY CENTER CHILD CARE
FACILITY NUMBER: 213004686
VISIT DATE: 04/16/2025
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and the report was reviewed with the Director, Nicole Ramirez.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2025
LIC809 (FAS) - (06/04)
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