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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005569
Report Date: 09/26/2023
Date Signed: 09/26/2023 11:17:59 AM

Document Has Been Signed on 09/26/2023 11:17 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:GOMES, ALINNEFACILITY NUMBER:
214005569
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/26/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Alinne GomesTIME COMPLETED:
11:40 AM
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On September 26, 2023, at 9:30 AM, Licensing Program Analyst (LPA) Nathan Garcia met with the Licensee, Alinne Gomes for an announced Pre-Licensing relocation and increase capacity inspection. The Licensee has relocated from Facility #214005630 to this location. The purpose of the inspection was explained, and the Licensee granted LPA entry to the home. This is a single-family home. The Licensee applied for a large license and was granted by the fire inspector on 9/14/23. There were no children present during the visit. Operation hours are Monday – Friday from 07:30 am – 5:30 pm.

Childcare areas: are the living room, bedroom #1 and #2, a full bath and back yard.
Off-limit areas: are master bedroom and bathroom, front yard, dining room, garage and kitchen.

Licensee and LPA inspected the home for health and safety Hazards. The home has age-appropriate toys and equipment available for children in care. The home has a working smoke and carbon monoxide detector, a working telephone, and a fully charged 3A40BC fire extinguisher. First Aid Kit is fully stocked and accessible. There are no pools, spas, or bodies of water on the property. All cleaning supplies, poisons, and other chemicals are inaccessible to children and stored in the closet. All harmful and sharp objects are made inaccessible to children in care. The Licensee stated there are no guns and weapons. There are 2 pet dogs in the home.

LPA reminded the Licensee to conduct an emergency drill and log drills are required. Per licensee, they have emergency drills at least 3 times a year. The licensee and helper's First Aid/CPR certificate is valid until 8/2024 and 2/2025. The Licensee had all posting requirements posted near the front door. The Licensee is reminded of no walkers, jumpers, bouncers, or any similar items to be used for children in care and shall be made inaccessible. In addition, smoking is prohibited at the day-care. Central Marin Fire Department granted fire clearance on 9/14/23.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2023
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: GOMES, ALINNE
FACILITY NUMBER: 214005569
VISIT DATE: 09/26/2023
NARRATIVE
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The applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

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: http://www.ada.gov/childqanda.htm

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Licensee was informed of the MyChildCarePlan.org site, 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.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: GOMES, ALINNE
FACILITY NUMBER: 214005569
VISIT DATE: 09/26/2023
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***Page 3 Continued***

Control of Property/Lease agreement on file.
Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

LPA observed that the play yard is fully barricaded and has swing with padded floors. The outdoor area has turf installed with toy cars and a sandbox that is covered when not in use.
There are functioning smoke and carbon monoxide alarms in all the rooms. Licensee will be using one of the bedrooms when a child is sick. The day care area is properly barricaded to prevent children from entering off limits area. The licensee states that she will transfer liability insurance to this new location once it is licensed. LPA also reviewed that the mandated reporter certificates are still valid.

A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Licensee will receive the updated license through mail.

Exit interview was conducted and report was reviewed with the Licensee, Alinne Gomes.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023
LIC809 (FAS) - (06/04)
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