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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005542
Report Date: 03/15/2024
Date Signed: 03/15/2024 04:27:24 PM

Document Has Been Signed on 03/15/2024 04:27 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:DURAN, MARIA C.FACILITY NUMBER:
214005542
ADMINISTRATOR:DURAN, MARIA C.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 521-9419
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
03/15/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Licensee, Maria DuranTIME COMPLETED:
04:40 PM
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On 3/15/2024, Licensing Program Analysts (LPAs) Hanson Leong and Melissa Zaragoza conducted an unannounced Plan of Correction (POC) visit to the Family Childcare Home (FCCH) listed above. The visit was to address three deficiencies cited on 3/7/2024—two Type A and one Type B. During the visit, LPAs met the Licensee, Maria Duran, and explained the purpose of the visit.

LPAs inspected her home to ensure that the FCCH was within the license’s capacity. LPAs conducted a walk-through of the entire property and discovered that the licensee and two staff members were taking care of eleven children, consisting of four infants and seven preschool-aged children.

LIC 9182, Criminal Background Clearance Transfer Request, was given to the licensee to fill out to transfer the staff member to her FCCH. LPAs observed that the licensee signed the LIC 9182. The staff member was officially transferred to her FCCH on 3/15/2024. A copy of the staff member’s background check clearance was given to the licensee.

Based on the licensee's interview, the child who allegedly caused the overcapacity on 3/7/2024 was not part of the daycare. According to the licensee, the child’s parent was inquiring about her program. Based on the LPAs' record review, the child was not listed on the FCCHs roster.

The three citations, CCR 102370(d), CCR 102416.5(d)(1), and CCR 102421(a) will be cleared during the visit. Three cleared POC letters were given to the licensee.

No deficiencies were issued today during LPA's visit.

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

Exit interview conducted and report was reviewed with the Licensee, Maria Duran

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2024
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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