214005663-11-15-2023-05-CC-JTSE-CXLQK2-20231115111337

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005663
Report Date: 11/15/2023
Date Signed: 11/15/2023 11:14:00 AM

Document Has Been Signed on 11/15/2023 11:14 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NOLETO, MARIA P.		FACILITY NUMBER:	214005663
ADMINISTRATOR:	NOLETO, MARIA P.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 472-2816
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	11/15/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Applicant, Maria Noleto		TIME COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 11/15/2023, at approximately 8:55AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an announced prelicensing visit at the address listed above. LPA was granted entry to the home by applicant, Maria Noleto. LPA explained the purpose of the visit. Present during the visit was the applicant. All adults in the home are fingerprint cleared and associated. Applicant lives with her husband, whose name is on the mortgage, and her adult daughter. Applicant stated that she intends to purchase liability insurance for the day care. Applicant intends to enroll children from the age of three months and up. The home is a single-level five-bedroom, two bathroom home, with a daycare area (converted from garage), dining room, kitchen, living room, and a backyard (fenced into two sections, one for daycare and one that is off-limits). Daycare Areas: Daycare 1, Daycare 2, Daycare 3, Daycare 4 (backyard 2), Bathroom 1. Off-limits Areas: Bedroom 1, Bedroom 2, Bedroom 3, Bathroom 2, Kitchen, Dining Room, Living Room, Backyard 1. LPA and Applicant inspected the home for any health and safety hazards. LPA observed that off-limits areas are sufficiently barricaded with childproof gates. Bathroom 1 was observed to not have childproof locks on the sink cabinets. LPA advised Applicant to acquire childproof locks for Bathroom 1 as part of the requirement for licensure. Soaps, detergents, and other chemicals are stored inaccessible to children. The home is equipped with a charged 2A10BC fire extinguisher. Applicant demonstrated the carbon monoxide detector to be operational during the visit. There is a fire alarm installed in the home. Fire clearance was approved for the home on 11/2/2023. LPA observed the first aid kit to contain all materials necessary for the administration of first aid. Continued on Page Two

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOLETO, MARIA P.	FACILITY NUMBER: 214005663
	VISIT DATE: 11/15/2023

NARRATIVE

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Daycare Area 1 is a converted garage. LPA observed Daycare Area 1 to be equipped with toys and age-appropriate learning materials. All electrical outlets were covered or otherwise obstructed by furniture to be inaccessible to children when not in use. There is a smoke detector and a carbon monoxide detector present. Per Applicant, she intends to install a heater along the wall of Daycare Area 1. Until that heater is installed, a heater present in Daycare Area 2 will be used. The heater will be kept in a barricaded area of Daycare Area 2 that is inaccessible to children.

Daycare Area 2 is equipped with a diaper changing station and a smoke detector. There is a refrigerator and a microwave that are barricaded by a childproof gate. Per applicant, Daycare Area 2 is only meant for eating and diaper changing, in addition to being an isolation area for sick children.

Daycare Area 3 is a bedroom that is meant for infant sleep. Per Applicant, the room will only be used when infants need to sleep. There is one play yard present in the room. Applicant will purchase more cribs and play yards as infant enrollment increases.

Daycare Area 4 is a section of the backyard that has been fenced off. There is no access from Daycare Area 4 to Backyard 1 without going back into the home first. Applicant has equipment for the backyard area stored inside Daycare Area 1 and intends to purchase more toys and age-appropriate equipment.

All toys and equipment present in the home were observed to be in functional condition. Applicant’s First Aid/CPR certification expires 9/2025 and Mandated Reporter Training expires 9/26/2025.

Applicant was reminded that baby walkers, bouncers, jumpers and any other similar items are not to be used for children in care. LPA reminded applicant emergency disaster drills are to be conducted and documented at least once every six months.

The designated isolation area will be Daycare Area 2, separate from other children in care. LPA reminded applicant that children must be supervised at all times. Applicant plans to provide a food service that includes morning and afternoon snack, in addition to breakfast and lunch. Food preparation, sanitization, children's allergies was discussed.
Continued on Page Three

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOLETO, MARIA P.	FACILITY NUMBER: 214005663
	VISIT DATE: 11/15/2023

NARRATIVE

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LPA reminded applicant CPR/First Aid training and Mandated Reporter training must be renewed every two years. Applicant was also reminded Mandated Reporter training must be renewed every two years by all staff working with children. Applicant has proof of required immunizations that were provided to department. Per applicant, there are no weapons or firearms in the home.

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, 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.

The applicant provided proof of control of property.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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 applicant 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 the applicant.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage 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.
Continued on Page Four

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOLETO, MARIA P.	FACILITY NUMBER: 214005663
	VISIT DATE: 11/15/2023

NARRATIVE

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On this date, 11/15/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly
cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant 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.

Exit interview conducted and report was reviewed with the applicant, Maria Noleto.

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.

Prior to licensure, Applicant is required to:

provide proof of purchase of additional toys
provide proof of additional mats/carpet for Daycare Area 1
provide proof of childproof locks installed in Bathroom 1

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

LIC809 (FAS) - (06/04)

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