214005724-6-16-2026-05-CC-CQUO-DV4V9B-20260616161405

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005724
Report Date: 06/16/2026
Date Signed: 06/16/2026 04:15:27 PM

Document Has Been Signed on 06/16/2026 04:15 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:	HUMMINGBIRDS COLLABORATIVE SCHOOL		FACILITY NUMBER:	214005724
ADMINISTRATOR/ DIRECTOR:	MELINDA RICHARD		FACILITY TYPE:	860
ADDRESS:	1929 NOVATO BLVD.		TELEPHONE:	(415) 760-6197
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 33	CENSUS: 0	DATE:	06/16/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Melinda Richard		TIME VISIT/ INSPECTION COMPLETED:	04:35 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 June 16, 2026 at approximately 9:30am, Licensing Program Analysts (LPAs) Quimbo and Tran conducted a scheduled, pre-licensing visit. LPAs met with licensee/applicant/director, Melinda Richard, and explained the purpose of the visit. Also present during visit included assistant director, April Jackson. This is a relocation application. Licensee is currently licensed at facility 214005477. Application was submitted February 3, 2026. Licensee is requesting for a total capacity of 48 preschool children (2 years to 5 years old). Fire clearance for a total capacity of 48 children was received on May 29, 2026. The facility will operate Monday through Friday 7:30am to 5:00pm. Facility includes a director's office, 3 classrooms, storage room, kitchen, girls restroom and boys restroom. Child care will be provided in 3 classrooms, girls restroom, boys restroom and outdoor area only. LPAs inspected day care areas for health and safety hazards and measured day care areas. Preschool Indoor measurements are: There are 3 preschool classrooms that will be utilized for the preschool component: Classroom #202, #203, and #204. The indoor area contains a total of 1, 377.43 square feet which will not accommodate applicant's request of 48 preschool children. Preschool Outdoor measurements are: There is 1 large outdoor area that surrounds the entire facility. The outdoor area contains a total of 8,077.46 square feet which will accommodate applicant's request of 48 preschool children. (Continue report on page 2...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026

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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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: HUMMINGBIRDS COLLABORATIVE SCHOOL	FACILITY NUMBER: 214005724
	VISIT DATE: 06/16/2026

NARRATIVE

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Preschools sinks and toilets:
There are 3 sinks, 3 toilets and 1 urinal available for preschools' use. Toilet and sink ratio is sufficient to accommodate applicant's request for 48 preschool children.

The child care center was observed to be clean, sanitary and in good repair. A comfortable temperature for children is being maintained. Furniture and equipment were observed to be maintained in good condition. Furniture and equipment were also observed to be free of sharp, loose or pointed parts. Tables and chairs are age-appropriate. There are rugs in the classroom that were observed to be clean and free of stains. Per licensee, rugs are vacuumed daily. Floors are also swept daily. LPAs observed electrical outlets in day care areas to be covered and made inaccessible.

LPAs observed children's restrooms to be in working condition. There will be a diaper changing table in the girls' restroom that will be within arm's reach to a sink. Per licensee, diapers and wipes will be provided by children's families and stored in the restroom. LPAs discussed labeling of children's personal materials. Diapering sinks are not used for meal preparation or dishwashing. There will be a garbage bin with a tight fitting lid to dispose of dirty diapers. Sinks accessible to children provide warm water that will be turned off.

Preschool children will sleep on floor mats in their classrooms. Per licensee, floor mats will be labeled to indicate which side will be floor touching and which side will be for the child to rest on. Sheets are provided by the program and are laundered weekly. Blankets are provided by children's families and will be sent home weekly for laundering. LPAs reminded licensee children's sheets and blankets are not to be touching each other.

Facility is equipped with a fully stocked first aid kit and emergency backpack. Facility also includes multiple fully charged fire extinguishers, smoke and fire alarm system, smoke detectors, and multiple combination smoke and carbon monoxide detectors. LPAs tested two carbon monoxide detectors during today's visit which were observed to be in working condition.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes 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
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026

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: HUMMINGBIRDS COLLABORATIVE SCHOOL	FACILITY NUMBER: 214005724
	VISIT DATE: 06/16/2026

NARRATIVE

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Licensing documents are posted on a bulletin board in front of the facility. Children will be signed in and out of the program with written signatures. LPAs reminded licensee sign in sheets are to be maintained for 30 days.

Outdoor area is fully enclosed and fenced. Outdoor area also surrounds entire facility. There is a play structure in the front outdoor area (facing parking lot), that is separately fenced and enclosed. Play structure is labeled for children's usage of 3 years to 10 years old. LPAs observed play structure to have resilient padding underneath.

Outdoor area includes a variety of outdoor toys and equipment that are in good condition. Per licensee, toys and materials will be sanitized at least once a month or as needed. There is a sandbox that is covered when not in use. LPAs did not observe any pools, spas or bodies of water on site.

Program will provide a food service for children that will include snacks and lunch. Food will be cooked and prepared in on site kitchen. Reusable dishes and materials will be utilized and sanitized daily on site, through a dishwasher. Food menu is posted and made available for review. Drinking water is available through filtered water dispensers. Per licensee, water is delivered daily.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPAs reviewed with licensee, the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Licensee 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 athttps://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026

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: HUMMINGBIRDS COLLABORATIVE SCHOOL	FACILITY NUMBER: 214005724
	VISIT DATE: 06/16/2026

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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

Licensee was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides 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 Child Care Center. 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.

Based on indoor square footage, the maximum capacity facility will be licensed for will be 39 preschool children.

Prior to recommended licensure, following is to be completed:
-Updated Application for Child Care Center License (LIC200A) with updated capacity.
-Updated fire clearance with updated capacity.
-Installation of a child safety gate on closet in classroom #204.
-Fixing of cracked window in classroom #203.
-Installation of sound alarms for each exit door in each classroom (6 doors total).
-Covering heater vent in classroom #202.
-Installation of child safety gate surrounding fireplace in classroom #202.
-Covering of lighting in classroom #202.
-Installation of child safety locks on cabinets in children's restrooms.
-Repairing door hinge on fire panel door in outdoor area.
-Moving of outdoor shed from outdoor area.
-Installation of child safety door handle on storage room door.
-Additional resilient padding placed under play structure in outdoor area.
-Centralized Application Bureau (CAB) final approval of application.

Upon license approval of facility 214005724, facility 214005477 will permanently close.

Exit interview conducted and report was reviewed with licensee, Melinda Richard.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026

LIC809 (FAS) - (06/04)

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