214005663-10-9-2024-05-CC-HLEG-D9VVAQ-20241009161618

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005663
Report Date: 10/09/2024
Date Signed: 10/09/2024 04:18:16 PM

Document Has Been Signed on 10/09/2024 04:18 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:	NOLETO, MARIA P.		FACILITY NUMBER:	214005663
ADMINISTRATOR/ DIRECTOR:	NOLETO, MARIA P.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 472-2816
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 5	CENSUS: 3	DATE:	10/09/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:37 PM
MET WITH:	Maria Noleto		TIME VISIT/ INSPECTION COMPLETED:	04:25 PM

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On 10/9/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit and met with the Licensee, Maria Noelto. LPA explained the purpose of the visit to the licensee.

Three infants and two adults (the licensee and the licensee’s adult daughter) were present during today’s visit. The licensee and the licensee’s adult daughter received criminal record clearance from the department. The licensee holds a large license and is within capacity limits and ratios for today’s visit.

LPA observed that all required documents, such as the facility license, the Notification of Parental Rights, and the Earthquake Preparedness Checklist, were displayed and visible to the public.

According to the licensee, she has not conducted an emergency disaster drill for this year. LPA reminded that the emergency disaster drills must be conducted and recorded.

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. The licensee understands that off-limits areas may not be used for childcare during business hours.

LPA conducted inspections of the indoor and outdoor daycare areas to identify health and safety hazards. The home has a fire extinguisher, a first aid kit, and multiple carbon monoxide and smoke detectors. LPA found the home's interior clean and orderly, with proper heating and ventilation for safety and comfort. Disinfectants, cleaning solutions, poisons, and other hazardous items were stored in areas inaccessible to children. The bathroom was found to be clean and fully operational. The toilet and handwashing facility were well-kept, safe, and clean. The bathroom is equipped with appropriate toileting equipment and appropriate sanitation products. A diaper changing station, including diapers and wipes, was observed to be present in the home.

LPA observed that the daycare areas had age-appropriate toys, furniture, and educational materials. Electrical outlets were covered with child safety covers. According to the licensee, no firearms or weapons are on the premises.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024

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: NOLETO, MARIA P.	FACILITY NUMBER: 214005663
	VISIT DATE: 10/09/2024

NARRATIVE

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The backyard is enclosed by a fence and equipped with outdoor play equipment that is in good condition. The areas around and under high climbing equipment, swings, slides, and similar equipment were observed to be cushioned with grass. LPA did not observe any pools, spas, or bodies of water on site.

The children's parents or guardians are required to provide formula for their children. Per the licensee, no children enrolled currently have any allergies. The facility provides snacks for the children.

Playpens are available for the children to rest or take a nap. The playpens are free of loose articles and materials.

LPA reviewed three children’s files and confirmed that all three have complete files that include their emergency contact and medical information. Records of 15-minute sleeping checks for children under two were not available for review. According to the licensee, she performs visual sleep checks and does not have records of 15-minute sleep checks for children under two. Form LIC 282, Affidavit Regarding Liability Insurance For Family Child Care Home, was missing from the children’s files. LPA reminded the licensee that form LIC 282 must be completed and placed in the child’s file.

LPA reviewed the licensee’s file and confirmed that all required forms were present. LPA found that the licensee possesses a current Pediatric First Aid/CPR certification, which expires on 9/2025.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

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: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024

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: NOLETO, MARIA P.	FACILITY NUMBER: 214005663
	VISIT DATE: 10/09/2024

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LPA discussed the safe sleep regulations with licensee 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 licensee 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.

Licensee was informed of the MyChildCarePlan.org website; 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.

During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Two technical violations were issued to the facility, which are listed below.

1. Failing to conduct an emergency disaster drill at least once every six months.

2. Failing to document emergency disaster drills.

TECHNICAL VIOLATION: Violations of the Health and Safety Code (HSC), regulations (CCR), or interim licensing standards (ILS) that do not pose a health, safety or personal rights risk.

Please see LIC 809D for today’s violation.

The facility’s appeal rights were given to the licensee.

A Notice of Site Visit was given and must remain posted for 30 days.

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

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/09/2024 04:18 PM - It Cannot Be Edited

Created By: Hanson Leong On 10/09/2024 at 03:38 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: NOLETO, MARIA P.	FACILITY NUMBER: 214005663
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)(D)(c)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 10/25/2024
	Plan of Correction
1 2 3 4	The licensee will be required to submit records of the 15-minute sleep checks for children under two years old from 10/10/2024 to 10/24/2024 by the due date mentioned above.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Daniel J Oquendo

LICENSING EVALUATOR NAME:

Hanson Leong

LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024

LIC809 (FAS) - (06/04)

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