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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005685
Report Date: 08/07/2024
Date Signed: 08/07/2024 09:49:24 AM

Document Has Been Signed on 08/07/2024 09:49 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:RODRIGUES, ADRIANYFACILITY NUMBER:
214005685
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 6TOTAL ENROLLED CHILDREN: 1CENSUS: 1DATE:
08/07/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:57 AM
MET WITH:Adriany RodriguesTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 8/7/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced case management visit to the Family Childcare Home (FCCH) listed above. The licensee, Adriany Rodrigues, requested that a room be added to her daycare. LPA met with the Licensee and explained the purpose of the visit.

One child and four adults (the licensee, the licensee’s husband, and two adult residents) were present during the visit. The four adults received criminal record clearance from the department.

LPA inspected Bedroom #1 to identify any potential health and safety hazards. Bedroom # 1 will primarily serve as an area for children to nap. The space is well-maintained and features appropriate ventilation and heating. Electrical outlets and an open floor space heater were observed to be properly covered. Additionally, playpens are readily available for the children to nap in. Furthermore, Bedroom # 1 is equipped with a functioning carbon monoxide detector located outside of the room and a smoke detector in the room.

The LPA will recommend Bedroom # 1 be added to her daycare, effective 8/7/2024.

A copy of today's report was given to the Licensee, Adriany Rodrigues.

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

Exit interview conducted and report was reviewed with the Licensee, Adriany Rodrigues.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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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