214005398-3-6-2026-05-CC-JNAS-DRWVCJ-20260306151913

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005398
Report Date: 03/06/2026
Date Signed: 03/06/2026 03:19:33 PM

Document Has Been Signed on 03/06/2026 03:19 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	ALVAREZ, ALCIRA		FACILITY NUMBER:	214005398
ADMINISTRATOR/ DIRECTOR:	ALVAREZ, ALCIRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 728-5449
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY: 10	TOTAL ENROLLED CHILDREN: 10	CENSUS: 6	DATE:	03/06/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:25 PM
MET WITH:	Alcira Alvarez		TIME VISIT/ INSPECTION COMPLETED:	03:40 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 3/6/2026, Licensing Program Analyst (LPA) Naves conducted an unannounced required visit to the Family Childcare Home (FCCH) listed above. During the visit, LPA met the licensee Alcira Alvarez and explained the purpose of the visit and was granted entry. Present in the home during today was Licensee and an assistant supervising six children (2 infants and 4 preschool-aged children). All adults present at the FCCH have received fingerprint clearance from the department. The FCCH operates within its capacity and in accordance with the required ratio of staff to children. A dog was present in the home and is fully vaccinated. Daycare Areas: Living room, Balcony adjacent to living room (not currently in use due to hole in balcony floor) Full bathroom, Half bathroom, and Bedroom #2. Off Limit Area(s): Bedroom #1, Kitchen, and Closet in the hallway. The licensee understands that off-limits areas may not be used for childcare during business hours. Licensees hours of operation are Monday- Friday 7:30am-5:30pm. Licensee provides a meal service for children in care. Breakfast, lunch and snack. Licensee currently uses a nearby park as outdoor time for children. Lic 126 Entrance Checklist was provided to licensee. LPA and the licensee conducted an inspection to identify any potential health and safety hazards. LPA observed that the indoor daycare areas appeared to be clean and orderly. LPA observed that the indoor daycare areas were equipped with age-appropriate toys, furniture, and educational materials. The FCCH is well-lit, ventilated, and free of hazards that could endanger children. cont pg 2 >>>>

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ALVAREZ, ALCIRA	FACILITY NUMBER: 214005398
	VISIT DATE: 03/06/2026

NARRATIVE

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The FCCH is equipped with a fully stocked first aid kit, a functioning smoke detector and carbon monoxide detector, (not tested due to children napping) and a fully charged fire extinguisher. LPA observed that all garbage cans and power outlets were appropriately covered. LPA found that all cleaning products were stored out of children’s reach and made inaccessible. LPA observed that no equipment, such as walkers, bouncers, or similar objects, was present in the FCCH. LPA observed a safety gate surrounding the balcony. According to the licensee, no firearms or weapons are on the premises.

LPA observed that the FCCH has no pools, spas, or other bodies of water

LPA observed that the FCCH has a specific sleeping/resting area for children. The areas were equipped with playpens, cots, mattresses, and blankets, which appeared to be comfortable and safe for the children to sleep in. LPA also observed a clean diaper-changing station in the Full Bathroom, complete with wipes and diapers. The infant mattresses appeared to be firm and covered with a fitted sheet appropriate to their size. The sheet appeared to fit tightly on the mattress and overlapped the underside. LPA observed a napping child with a pacifier with an attached toy, LPA reminded licensee pacifiers must not have anything attached to them.
The LPA observed that all required documents, such as the facility license, the Notification of Parental Rights, were displayed in the FCCH.LPA provided licensee with the Earthquake Preparedness Checklist to add to required postings.
According to the licensee, the most recent emergency drill was conducted in December 27,2025 and was properly logged as confirmed by the LPA's review of the log.

The LPA reviewed the records of both the children and staff members. According to the licensee, she carries Markell childcare insurance. The LPA reviewed all 6 children's records and found all necessary documents, including their Immunization Record, Identification/Emergency Information, Consent for Emergency Medical Treatment, and Notification of Parents’ Rights. The LPA reviewed the sleeping records of the two children under two and determined that the data was properly recorded. Following a review of the staff records, LPA found that the licensee and the licensee's assistant possess a current certification in Pediatric First Aid/CPR.
cont pg 3>>>>

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ALVAREZ, ALCIRA	FACILITY NUMBER: 214005398
	VISIT DATE: 03/06/2026

NARRATIVE

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The licensee’s Pediatric First Aid/CPR certification expires on 2/2028. Licensees Mandated Reporter training certificate expires 3/2026. LPA found staff files to be complete with all required documents and immunizations.

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.

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/.
LPAs 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. LPAs 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 licensee confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.
cont pg 4 >>>>

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ALVAREZ, ALCIRA	FACILITY NUMBER: 214005398
	VISIT DATE: 03/06/2026

NARRATIVE

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On this date, 3/5/26, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.
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.

The 80/20 attendance expectation was discussed with licensee stated that they understand that they are the primary person responsible for operating and providing care and supervision to the children, regardless if the licensee hires helpers or assistants to work with them. Licensee understands that they may only be absent from the home no more than twenty percent of the operating hours. During the twenty percent absence licensee understands that they may designate another person to provide care and supervision to the children who is qualified with Mandated Reporter Training, Pediatric CPR and First Aid Training, has obtained criminal record clearances, child abuse index checks, a TB test with results, immunizations as required by law, and has a signed Criminal Record Statement and Acknowledgement to Report Suspected Child Abuse forms.
No deficiencies were cited during todays visit.

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.

A copy of today’s report was given to the Licensee Alcira Alvarez.

Exit interview conducted and report was reviewed with the Licensee, Alcira Alvarez

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

LIC809 (FAS) - (06/04)

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