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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005657
Report Date: 10/10/2023
Date Signed: 10/10/2023 11:47:47 AM

Document Has Been Signed on 10/10/2023 11:47 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:OLIVEIRA, YARAFACILITY NUMBER:
214005657
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
10/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Yara OliveiraTIME COMPLETED:
12:00 PM
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On 10/10/2023, Licensing Program Analyst (LPA) Hanson Leong, conducted a scheduled, pre-licensing inspection with the Applicant, Yara Oliveira. Ms. Oliveira requested a visit from the department because she moved from another Family Child Care Home location. Before this visit, Ms. Oliveira was previously licensed under license # 214005543. The LPA was granted entry by Ms. Oliveira. The LPA explained the purpose of the visit to Ms. Oliveira. All individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. During today’s visit, there was a dog present in the home.

Ms. Oliveira rents the home. Ms. Oliveira intends to open from 7:45am to 5pm, Monday through Friday. Before children enroll, Ms. Oliveira states that she will purchase liability insurance for her home day care. The LPA informed Ms. Oliveira that if she does not purchase insurance for her childcare, she must notify the parents using the LIC 282 form. Ms. Oliveira plans to care for children ranging in age from newborn to two years old.

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

Day care area(s): Front yard, Living room, Bedroom # 1, Bathroom #1, and Backyard.

Off-limits area(s): Kitchen, Bedroom # 2, and Master Bedroom. Ms. Oliveira is aware of off-limits areas are not to be used during business hours.

Both LPA and Ms. Oliveira conducted a health and safety inspection of the home. The house is clean and safe, with a working smoke detector, carbon monoxide detector and a fire extinguisher. Ms. Oliveira 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. The LPA observed the children in care have access to age-appropriate toys and equipment. The LPA reminded Ms. Oliveira that ***See Page 2***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2023
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 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: OLIVEIRA, YARA
FACILITY NUMBER: 214005657
VISIT DATE: 10/10/2023
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baby walkers, bouncers, jumpers, and other similar equipment should not be used on children who are in care. Ms. Oliveira has a designated cell phone and is aware that it must be kept in the home during day care hours. According to Ms. Oliveira, 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 LPA observed napping playpens and cribs were present in Bedroom # 1.

The LPA reminded Ms. Oliveira 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. Ms. Oliveira has completed the Mandated Reporter Training. The LPA reminded that the Mandated Reporter Training must be renewed every two years. The LPA informed Ms. Olveira 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 is required if Ms. Oliveira provides care for a seventh and eighth 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.



LPA discussed the safe sleep regulations with Ms. Oliveira 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 Ms. Oliveira 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) or (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.

LPA reviewed with Ms. Oliveira the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to Ms. Oliveira.


***See Page 3***
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023
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: OLIVEIRA, YARA
FACILITY NUMBER: 214005657
VISIT DATE: 10/10/2023
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Ms. Oliveira 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, 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.

Ms. Oliveira 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 Ms. Oliveira.

Ms. Oliveira 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.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Ms. Oliveira 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.



The LPA will recommend a Small Family Child Care Home License for Ms. Oliveira. The license will take effect on 10/10/2023.

A copy of today's report was given to Yara Oliveira. An exit interview was conducted, and the report was reviewed with Yara Oliveira
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023
LIC809 (FAS) - (06/04)
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