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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005711
Report Date: 01/05/2026
Date Signed: 01/05/2026 01:14:21 PM

Document Has Been Signed on 01/05/2026 01:14 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MAJOULET, HEATHERFACILITY NUMBER:
214005711
ADMINISTRATOR/
DIRECTOR:		MAJOULET, HEATHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 225-5770
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 1DATE:
01/05/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Heather MajouletTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
NARRATIVE
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On December January 5, 2026, Licensing Program Analyst (LPA) Naves conducted an unannounced annual inspection and case management inspection for capacity increase request made by the Applicant, Heather Majoulet. The LPA explained the purpose of the visit to the applicant and entry was granted. The Licensee and adult daughter and 1 child (infant) were present during the visit. All adults have obtained clearance by the department to work or reside in the home.

Licensees hours of operation are 6:30am -6:00pm Monday- Friday.

Licensee was provided with entrance checklist for todays inspection.

Licensees home is 3 bedrooms, 2 bathroom 3 level home. Licensee lives in the home with her minor son and daughter and adult daughter. Licensee states there is a dog in the home and is current with vaccinations that does not interact with the children.
Day-care areas: Living room, Bathroom #1 and Kitchen/Dining area
The off-limit areas: Bathroom #2 and Bedroom #1, #2 and #3, Back Patio

Licensee stated that she mostly cares for school aged children. LPA and the Applicant inspected the entire home for Health and Safety Hazards. The home has sufficient lighting and ventilation. There are a variety of age-appropriate toys, puzzles, posters and books for the children. There are multiple sensory blocks/table and imaginative kitchen toys. All furniture and playthings were observed to be in good repair. The home has smoke detectors and a carbon monoxide detector installed. The home has a Fire Extinguisher model 3A10BC located in the kitchen. LPA reminded Heather that all harmful objects, sharp objects, and toxins are stored out of reach of children and made inaccessible to children.

cont pg 2 >>>>
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/05/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 01/05/2026 01:14 PM - It Cannot Be Edited


Created By: Jaclyn Naves On 01/05/2026 at 11:42 AM
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: MAJOULET, HEATHER
FACILITY NUMBER: 214005711

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in a bottle of clorox spray was on the ground in the bathroom and unlocked cabinets of kitchen had cleaning supplies which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/12/2026
Plan of Correction
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Licensee will install locks for all cabinets with poisons and keep all poisons out of reach of chilren at all times by end of business day 1/12/26.
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on obsd document the following:

This requirement is not met as evidenced by:ervation ,interview and record review, the licensee did not comply with the section cited above in 1 infant in care did not have sleep logs documented which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/12/2026
Plan of Correction
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Licensee will begin doing sleep logs today and will keep a log for review for all children under 24 months.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:
Jaclyn Naves
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/05/2026


LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 01/05/2026 01:14 PM - It Cannot Be Edited


Created By: Jaclyn Naves On 01/05/2026 at 11:42 AM
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: MAJOULET, HEATHER
FACILITY NUMBER: 214005711

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation,interview and record review, the licensee did not comply with the section cited above in infant in care did not have a record available which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/12/2026
Plan of Correction
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Licensee will have completed child record by due date above and of day.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation interview and record review, the licensee did not comply with the section cited above in there was no current childrens roster which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/12/2026
Plan of Correction
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Licensee will have updated roster by due date mentioned above by end of day.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:
Jaclyn Naves
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/05/2026


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: MAJOULET, HEATHER
FACILITY NUMBER: 214005711
VISIT DATE: 01/05/2026
NARRATIVE
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LPA observed that the bathroom is clean, however LPA observed cleaning products on the bathroom floor. LPA reminded licensee all cleaning supplies must be stored away and made inaccessible to children in care.

The applicant states that there are no guns/weapons in the home.

LPA reminded the licensee that emergency drills must be conducted at least once every six months and must be documented properly. The Licensee was reminded that NO baby walkers, exer-saucers, jumpers, bouncers, and any similar items to be used for children in care. The Applicant was also reminded that smoking is prohibited at the day-care.

Licensee provides food service for breakfast, lunch and AM/PM snacks. Licensee states that she has Progressive liability insurance and will send to LPA when she gets a copy of it.

Licensee has a current Pediatric First Aid CPR and Mandated Reporter Training certifications which will expire 3/2026. LPA reminded licensee to renew the certificates every two years.

LPA requested childs record in care and licensee was unable to provide. LPA reminded licensee every child under care must have a complete record as well as sleep logs for all infants (0-24mo) in care.

There is a community pool on the premises but it is only accessible through a key that each tenant possesses.

The Licensee 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

cont pg 3 >>>>
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: MAJOULET, HEATHER
FACILITY NUMBER: 214005711
VISIT DATE: 01/05/2026
NARRATIVE
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LPA discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep web page 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.

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: http://www.ada.gov/childqanda.htm

On this date, 1/5/2026, 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.

cont pg 4 >>>>
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: MAJOULET, HEATHER
FACILITY NUMBER: 214005711
VISIT DATE: 01/05/2026
NARRATIVE
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LPA reviewed with licensee Heather Majoulet the entrance checklist and sleep logs. LPA also reminded licensee of 102416.5 Staffing Ratio and Capacity requirements:
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:
(1) Twelve children, no more than four of whom may be infants; or
(2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.

If licensee is alone she must adhere to the limitations and operate as a small license.

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

Licensee has received clearance by the fire department and has obtained landlord consent for having a large license.
As of today, 1/5/2026 the facility will be licensed and approved for a Large Family Child Care License with a capacity of 14 total children when there is an assistant present.
See 809D for deficiencies cited today. Appeal rights given.
LPA reviewed 80/20 attendance expectation with licensee.
Notice of site visit was given and must remain posted for 30 days.
Exit interview was conducted and report was reviewed with the licensee, Heather Majoulet.
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jaclyn Naves
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC809 (FAS) - (06/04)
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