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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005602
Report Date: 11/08/2023
Date Signed: 11/08/2023 02:09:15 PM

Document Has Been Signed on 11/08/2023 02:09 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:FLAXMAN, CAROLINA S.FACILITY NUMBER:
214005602
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
11/08/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Carolina FlaxmanTIME COMPLETED:
02:30 PM
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On November 8, 2023, at approximately 1:00 PM, Licensing Program Analyst (LPA) Nathan Garcia conducted an announced inspection for increase of capacity today and met with licensee, Carolina Flaxman for her request to increase from a Small to a Large Family Child Care. Fire Clearance was received by Corte Madera Fire Department on 10/12/23. Present in the home are licensee, and one helper with a total of 5 children during nap time. All adults living and working in the home have fingerprint clearance and are associated to the facility.

Licensee owns the home, which is a 2 bedroom and 2 bathroom house with a backyard. Licensee lives in home with one minor child. The hours of operation are Monday-Friday from 8:00am-5:30pm. LPA and licensee inspected day care areas for health and safety hazards.

Day-care areas are: Bedroom #1 and #2, Living Room, Bathroom #1, backyard.
Off limit areas are: Dining Room and bathroom #2 in the master's bedroom and deck. All off limit areas, including all closets, are properly barricaded.

LPA observed home to be clean and in good repair with proper temperature and ventilation. There are a variety of age appropriate toys and equipment in the home which are in good condition. Home has a fireplace that is properly barricaded/sealed off. Backyard is fenced and properly barricaded. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children. There 2 fully charged fire extinguisher, and a working telephone. Per Licensee, there are no weapons or firearms in the home. Licensee has pet dog in the home that stays only at night. Licensee's CPR & First Aid expires on 08/2025. Licensee's Mandated Reporter certificate expires on 11/2025. Postings were posted near main door. Licensee is reminded of no walkers, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. Capacity limits of a Small and Large Family Child Care Home were explained.

LPA will recommend for approval of a Large Family Child Care Home License as of today, November 8th, 2023.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed by licensee, Carolina Flaxman.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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