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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005385
Report Date: 07/15/2024
Date Signed: 07/15/2024 11:40:48 AM

Document Has Been Signed on 07/15/2024 11:40 AM - 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:SIMOES, LILIAN & MARCELOFACILITY NUMBER:
214005385
ADMINISTRATOR/
DIRECTOR:
SIMOES, LILIAN & MARCELOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 521-5119
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
07/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:28 AM
MET WITH:Lilian and Marcelo SimoesTIME VISIT/
INSPECTION COMPLETED:
11:55 AM
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On 7/15/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit to the Family Childcare Home (FCCH) listed above. LPA met with the two Licensees, Lilian & Marcelo Simoes, and explained the purpose of the visit. The home did not have any children present. The facility is currently closed for the summer break and will reopen on 7/22/2024.

The licensee rents the home and lives with her husband and one adult child. The hours of operation are Monday through Friday from 8:00 a.m. to 4 p.m.

LPA observed that all required documents, such as the facility license, the Notification of Parental Rights, and the Earthquake Preparedness Checklist, were displayed in a prominent, publicly accessible location.

The most recent emergency disaster drill was conducted on 4/15/2024, and the LPA observed that it was properly documented. LPA reminded the licensee to complete and properly record emergency disaster drills every six months.

Day-care Areas: One of the bedrooms (napping only), Play / Activity area, Kitchen, Bathroom in the hallway, the side and backyard area for outdoor activities.

Off-Limit Areas: Three bedrooms, Living room, and Dining room. The licensees understand that off-limits areas may not be used for childcare during business hours.

LPA conducted inspections of the indoor and outdoor daycare areas to identify health and safety hazards. LPA found the home's interior to be clean and orderly, with proper heating and ventilation for safety and comfort. Disinfectants, cleaning solutions, poisons, and other items that could pose a danger were stored in the laundry room with a child safety door lock and were inaccessible to the children. The bathroom was found to be clean and fully operational. The toilet and handwashing facility were well-kept, safe, and clean.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2024
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SIMOES, LILIAN & MARCELO
FACILITY NUMBER: 214005385
VISIT DATE: 07/15/2024
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LPA observed that the daycare areas had age-appropriate toys, furniture, and educational materials. No equipment, such as walkers, bouncers, or similar objects, was present in the home. The fireplace was observed to be properly barricaded. The home was observed to have individual hooks for the children’s clothing and personal belongings. Electrical outlets were observed to be properly covered with child safety covers. According to the licensee, no firearms or weapons are on the premises.

The outdoor playground was enclosed by a fence, and the outdoor play equipment was safe for the children to use. The areas around and under high climbing equipment, swings, slides, and similar equipment were cushioned with material that absorbs falls. No bodies of water, such as pools or spas, were present on site.

According to the licensee, she provides food and snacks for the children. LPA reminded the licensee about the importance of sanitation and proper food preparation. Food and snacks were observed to be available for the children.

The sleeping/resting area was observed to be clean and sanitary. Sleeping mats, cribs, blankets, and sheets are available for children to use. LPA also observed that the infant mattresses were firm and appropriately covered with a fitted sheet appropriate to the size of the mattress.

LPA reviewed five children’s files and confirmed that all five children have complete files that include their emergency contact and medical information.



LPA reviewed the two licensees' files and confirmed that all required forms were present. LPA also found that the two licensees possess a current Pediatric First Aid/CPR certification expiring on 3/2026.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024
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: SIMOES, LILIAN & MARCELO
FACILITY NUMBER: 214005385
VISIT DATE: 07/15/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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-andresources/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.

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

During the exit interview, the licensees confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

One technical violation was issued for not completing emergency disaster drills every six months.

No deficiencies were issued today during LPA's visit.

A copy of today's report was given to the Licensee, Lilian Simoes. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Lilian Simoes.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024
LIC809 (FAS) - (06/04)
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