214005640-6-1-2023-05-CC-HLEG-CSDRPQ-20230601131220

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005640
Report Date: 06/01/2023
Date Signed: 06/01/2023 01:12:29 PM

Document Has Been Signed on 06/01/2023 01:12 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:	DUARTE, ANGELINA F.		FACILITY NUMBER:	214005640
ADMINISTRATOR:	DUARTE, ANGELINA F.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 464-0221
CITY:	MILL VALLEY	STATE: CA	ZIP CODE:	94941
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 1	DATE:	06/01/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Angelina Duarte		TIME COMPLETED:	01:25 PM

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On 6/1/2023, Licensing Program Analyst (LPA) Hanson Leong, conducted a scheduled, pre-licensing inspection with the Applicant, Angelina Duarte. The Applicant requested a visit from the department because she relocated from her previous home day care, and she also requested a Large Family Child Care license. Before this visit, the Applicant already held a license on one other occasion for thirteen months. The LPA was granted entry by the Applicant. The LPA explained the purpose of the visit to the Applicant. All the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. During the visit, the licensee’s daughter was present in the home.

The Applicant rents the home. The Applicant intends to open from 7:30 am to 5:00 pm, Monday through Friday. Before children enroll, the applicant states that she will purchase liability insurance for her home day care. The LPA informed the Applicant that if she does not purchase insurance for her childcare, she must notify the parents using the LIC 282 form. The Applicant plans to care for children ranging in age from four months to five years old.

Daycare areas: Main Daycare Area, Sunroom Daycare Area, Bedroom #1 (Napping only), Side yard, Backyard, and a Bathroom.

Off-limits areas: Family Room, Kitchen, Office, Master Bedroom, Bedroom #2, Bedroom # 3, and a Second Sideyard

Both LPA and the Applicant conducted a health and safety inspection of the home. The home is clean and safe, with a working smoke, carbon monoxide detector and a fire extinguisher. The Applicant has a first aid kit that is fully stocked with all the necessary supplies for treating injuries. There are no bodies of water in the residence. The Applicant has garbage cans with tightly fitting covered lids. At the home, the children in care have access to age-appropriate toys and equipment. The LPA reminded the Applicant that baby walkers, bouncers, jumpers, and other similar equipment should not be used on children who are in care.

***See Page 2 for continuation***

Daniel J Oquendo
Hanson Leong
	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2023

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: DUARTE, ANGELINA F.	FACILITY NUMBER: 214005640
	VISIT DATE: 06/01/2023

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The Applicant has a designated cell phone and is aware that it must be kept in the home during day care hours. According to the Applicant, there are no firearms or weapons in the home. The front of the home will be the isolation area for a sick child. All hazardous materials and toxins are kept out of children's reach and are inaccessible. The Applicant intends to serve snacks to the children. The LPA observed resting mats and a playpen were present in the designated napping room.

The LPA reminded the Applicant that the CPR and First Aid training must be renewed every two years. The Applicant has proof that she has received the MMR and TDAP vaccinations. The Applicant has completed the Mandated Reporter Training. The LPA reminded the Applicant that the Mandated Reporter Training must be renewed every two years.

The LPA informed the Applicant that emergency disaster drills should be conducted at least once every six months and that the date and time of the drill should be recorded. Parental notification and landlord approval are required if the Applicant provides care for a thirteenth and fourteenth child who is of school age. Emergency Disaster Plan (LIC 610), Parent's Rights (LIC 995A), and License (once received) are required to be posted in an accessible location where parents can see them.

The LPA discussed the safe sleep regulations and the Child Care Licensing Safe Sleep with the Applicant, webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. The LPA also informed the Applicant 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 with the Applicant. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm ***See Page 3 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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: DUARTE, ANGELINA F.	FACILITY NUMBER: 214005640
	VISIT DATE: 06/01/2023

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A packet of forms pertaining to the children’s files and facility files were reviewed and discussed with the Applicant. The Applicant was advised all assistants, volunteers, frequent visitors, or adults living in the home, over the age of 18 must be fingerprint cleared, associated to the home, and have proof of immunization, prior to having any contact with the children in care. Failure to do so could result in an immediate civil penalty of $100 per person, each day.

The Applicant was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. The LPA reviewed AB 1207 with the Applicant.

The LPA will not recommend a Large Family Child Care Home License for the Applicant until the following condition is met.
1. Fire Clearance from the Fire Department.

The Applicant was advised to contact San Bruno Regional Office for concerns or questions. Desk Duty is available Mon-Fri, 8:00am to 5:00pm at (650) 266-8800. Forms and regulations are made available at www.cdss.ca.gov/inforesources/Community-Care-Licensing.

A copy of the report was given to Angelina Duarte. An exit interview was conducted, and the report was reviewed with Angelina Duarte.

SUPERVISOR'S NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

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