214005671-1-9-2024-05-CC-HLEG-CZC235-20240109160145

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005671
Report Date: 01/09/2024
Date Signed: 01/09/2024 04:01:52 PM

Document Has Been Signed on 01/09/2024 04:01 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:	MORALES, EDINA		FACILITY NUMBER:	214005671
ADMINISTRATOR:	MORALES, EDINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 948-7617
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS:	DATE:	01/09/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Edina Morales		TIME COMPLETED:	04:15 PM

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 1/9/2024, Licensing Program Analyst (LPA) Hanson Leong made a scheduled pre-licensing inspection with the Applicant, Edina Morales. The LPA was granted entry by the Applicant, Edina Morales. The applicant requested a visit from the department as she will be relocating from another Large Family Child Care Home location. The applicant’s current license # is 214005540. The LPA reminded the applicant that once they moved, license # 214005540 would be invalid, and using the home for childcare would not be allowed. The applicant was informed of the reason for today's visit by the LPA.

The applicant rents the home and intends to operate from 6:00 am to 6:00 pm on weekdays, Monday through Friday. The applicant presented a photo of their previous childcare insurance to the LPA and stated that they would transfer it to the new location after obtaining a license. The applicant intends to care for children between the ages of two and five, and she will also provide meals for them during their stay.

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

Parental notification is 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.

Daycare areas: Living room, Bathroom, and Two parts of the backyard (the center and left side)

Off-limits areas: Front yard, Rooms # 1, #2, and #3, Garage, Kitchen, Bathroom (inside Room # 3) Right Side of the Backyard surrounded by a fence. All the areas inside the house that are off-limits to children are secured with a child safety lock.

See Page 2

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024

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: MORALES, EDINA	FACILITY NUMBER: 214005671
	VISIT DATE: 01/09/2024

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
26
27
28
29
30
31
32

Page 2
The LPA and the applicant thoroughly inspected the daycare facility to identify any possible health and safety risks. The areas where children are cared for are clean and safe. There was a working smoke detector and a carbon monoxide detector present. The applicant’s home has a 3A-40-BC fire extinguisher and a fully stocked first aid kit available for treating injuries. The toys and equipment provided for the children in care were age-appropriate. The LPA reminded the applicant that baby walkers, bouncers, jumpers, and other similar equipment should not be used for children in care. There are no bodies of water located on the property. The home had no sleeping equipment such as sleeping mats, playpens, cots, or cribs. The LPA observed power outlets were properly covered with child safety covers. The LPA observed that the fireplace is appropriately covered and surrounded by a gate. During today’s visit, the applicant stated that the children in their care will require a diaper changing station. However, upon inspection of the home, it was observed that no such station was present.

LPA discussed the safe sleep regulations with the applicant 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 the 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.

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 the 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.

See Page 3

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024

LIC809 (FAS) - (06/04)

Page: 2 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: MORALES, EDINA	FACILITY NUMBER: 214005671
	VISIT DATE: 01/09/2024

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
26
27
28
29
30
31
32

Page 3
The 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 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 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.

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.

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.

The LPA reminded the applicant that care must be provided within the capacity limits specified in the license. The capacity limits of a Large License have been reviewed with the licensee. The applicant is reminded that if no assistant provider is present at a Large Family Child Care Home, the applicant shall comply with the capacity requirements for a Small Family Child Care Home. The LPA reminded the applicant a Small Family Childcare Home may provide care for more than six and up to eight children,

The LPA will not recommend a Large Family Child Care license until the facility obtains fire clearance, sleeping equipment such as sleeping mats, cots, cribs, playpens, and a diaper changing station.

A copy of today’s report was given to Edina Morales. Exit interview conducted and report was reviewed with Edina Morales.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3