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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005444
Report Date: 07/23/2024
Date Signed: 07/23/2024 04:53:23 PM

Document Has Been Signed on 07/23/2024 04:53 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:MUNOZ, VICTORIA AND GARAY, JUANFACILITY NUMBER:
214005444
ADMINISTRATOR/
DIRECTOR:
MUNOZ, VICTORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 455-9621
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
07/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:42 PM
MET WITH:Victoria Munoz & Juan GarayTIME VISIT/
INSPECTION COMPLETED:
05:00 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 7/23/2024, 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, Victoria Munoz & Juan Garay, and explained the purpose of the visit.

Thirteen children (three infants, eight pre-k, and two school-aged) and the two licensees were present during the visit. The two licensees received criminal record clearance from the department. The licensee holds a large license and is within capacity limits and ratios.

The licensees own the home and live with their mother. The hours of operation are Monday through Friday from 7:30 a.m. to 5:00 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 4/19/2024, and the LPA observed that it was properly documented. LPA reviewed the emergency disaster drill log and found that they were conducted every six months.

Day-care Areas: Living room, Dining room, Bedroom (facing the street is for napping), Bathroom (in the hallway).

Off-limits areas: Kitchen, two bedrooms, and the Garage. The licensees understand that off-limits areas may not be used for childcare during business hours.

See Page 2

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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 5
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: MUNOZ, VICTORIA AND GARAY, JUAN
FACILITY NUMBER: 214005444
VISIT DATE: 07/23/2024
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
26
27
28
29
30
31
32
Page 2

LPA conducted inspections of the indoor and outdoor daycare areas to identify health and safety hazards. A fire extinguisher, a first aid kit, and multiple carbon monoxide and smoke detectors are present in the home. 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 hazardous items were in the cabinets and were inaccessible to children. The bathroom was found to be clean and fully operational. The toilet and handwashing facility were well-kept, safe, and clean.

LPA observed two feeding chairs in the kitchen, which is in an off-limit area. LPA reminded the two licensees that the kitchen may not be used unless they submit a written request and receive approval from the department.

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. 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 area was enclosed by a fence and equipped with safe play equipment for the children. A fish pond was observed in the home, which was secured with a cover.

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 clean and sanitary. LPA observed cribs, mats, sheets, and blankets in the sleeping/resting area. LPA also observed that the infant mattress was firm and appropriately covered with a fitted sheet appropriate to the size of the mattress. LPA observed the playpen to be free of loose articles and materials.

See Page 3

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

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: MUNOZ, VICTORIA AND GARAY, JUAN
FACILITY NUMBER: 214005444
VISIT DATE: 07/23/2024
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
26
27
28
29
30
31
32
Page 3
LPA reviewed the files of five children and confirmed that all five children have complete files that include their emergency contact and medical information and sleep logs for children under two years old. LPA also reviewed the records of two school-aged children, and both children did not have proof they were attending elementary school.

LPA reviewed the two staff files and confirmed that all required forms were present. LPA found that the two licensees possess a current Pediatric First Aid/CPR certification, which expires on 12/2024.

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/.

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

See Page 4

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

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: MUNOZ, VICTORIA AND GARAY, JUAN
FACILITY NUMBER: 214005444
VISIT DATE: 07/23/2024
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
26
27
28
29
30
31
32
Page 4
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 to the facility for the off-limits area.

Please refer to LIC 809D for today’s citation.

A copy of today's report and the facility's appeal rights were given to the Co-Licensee, Juan Garay.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Co-Licensee, Juan Garay.

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

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 07/23/2024 04:53 PM - It Cannot Be Edited


Created By: Hanson Leong On 07/23/2024 at 04:43 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MUNOZ, VICTORIA AND GARAY, JUAN

FACILITY NUMBER: 214005444

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 07/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.5(g)
Staffing Ratio and Capacity
(g) For the purpose of meeting the criteria in Sections 1597.44 and 1597.465 of the Health and Safety Code, for a school age child who is under age six, the licensee shall maintain documentation verifying the child’s enrollment and attendance at kindergarten, including transitional kindergarten, or elementary
school.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the two licensees did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 08/23/2024
Plan of Correction
1
2
3
4
The licensees stated they would submit proof of school registration for the two school aged children by the due date mentioned above.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Daniel J Oquendo
LICENSING EVALUATOR NAME:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 07/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/23/2024


LIC809 (FAS) - (06/04)
Page: 5 of 5