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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214200085
Report Date: 07/16/2024
Date Signed: 07/16/2024 03:59:06 PM

Document Has Been Signed on 07/16/2024 03:59 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:GONZALEZ ORTEGA, DEVORAFACILITY NUMBER:
214200085
ADMINISTRATOR/
DIRECTOR:
GONZALEZ ORTEGA, DEVORAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 455-8138
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
07/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:51 PM
MET WITH:Devora Gonzalez OrtegaTIME VISIT/
INSPECTION COMPLETED:
04:10 PM
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On 7/16/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit to the Family Childcare Home (FCCH) listed above. LPA met with the Licensee, Devora Gonzalez Ortega, and explained the purpose of the visit.

Eight children (three infants, four pre-k, and one school-age), the licensee, and the licensee’s daughter (under the age of 18) were present during the visit. The licensee holds a large license and is within capacity limits and ratios. .

The licensee rents the home and lives with her husband and daughter (under the age of 18). The hours of operation are Monday through Friday from 8:00 a.m. to 6:00 p.m. and Saturday from 8:00 a.m. to 4:00 p.m. LPA observed a dog in the home, and according to the licensee, the dog is fully vaccinated.

LPA observed that all required documents, such as the facility license, the Notification of Parental Rights, and the Earthquake Preparedness Checklist, were displayed in a prominent, publicly accessible location.

The most recent emergency disaster drill was conducted on 3/4/2024, and the LPA observed that it was properly documented. LPA reviewed the emergency disaster drill log and found that they were conducted every six months.

The licensee requested the removal of the kitchen and Bedroom #2 from the daycare areas.

Day-care Areas: Living Room, Bathroom #2, Backyard and Deck

Off-limits Areas: Kitchen, Bedrooms #1 and # 2, Bathroom #1, and Front Yard. 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. LPA found the home's interior to be clean and orderly, with proper heating and ventilation for safety and comfort.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
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: GONZALEZ ORTEGA, DEVORA
FACILITY NUMBER: 214200085
VISIT DATE: 07/16/2024
NARRATIVE
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Disinfectants, cleaning solutions, poisons, and other items that could pose a danger were stored in the licensee’s room and were inaccessible to the children. The bathroom was found to be clean and fully operational. The toilet and handwashing facility were well-kept, safe, and clean. A diaper changing station is available for children to use.

LPA observed that the daycare areas had age-appropriate toys, furniture, and educational materials. No equipment, such as walkers, bouncers, or similar objects, was present in the home. The fireplace was observed to be properly barricaded. The home was observed to have individual permanent or portable storage space for the children’s clothing and personal belongings. Electrical outlets were observed to be properly covered with child safety. According to the licensee, no firearms or weapons are on the premises.

The outdoor playground was enclosed by a fence, and the outdoor play equipment was safe for the children to use. The areas around and under high climbing equipment, swings, slides, and similar equipment were cushioned with material that absorbs falls. No bodies of water, such as pools or spas, were present on site.

According to the licensee, the children are required to bring their own food. LPA reminded the licensee about the importance of labeling the child’s container with the child’s name and properly storing or refrigerating it. Snacks were observed to be available for the children.

The sleeping/resting area was observed to be clean and sanitary. Playpens, cots, cribs, sleeping mats, blankets, and sheets are available for children to use. LPA also observed that the infant mattresses were firm and appropriately covered with a fitted sheet appropriate to the size of the mattress.

LPA reviewed five children’s files and confirmed that all five children have complete files that include their emergency contact and medical information and sleep logs for children under two years old. LPA reminded the licensee to maintain a sleeping log, documenting the child’s sleep every 15 minutes for children under two years old.



LPA reviewed the licensee’s files and confirmed that all required forms were present. LPA found that the licensee possesses a current Pediatric First Aid/CPR certification expiring on 3/2025.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
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: GONZALEZ ORTEGA, DEVORA
FACILITY NUMBER: 214200085
VISIT DATE: 07/16/2024
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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/.

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.

The facility was issued a technical violation for failing to maintain a sleep log, detailing 15-minute checks for children under two years old.

No deficiencies were issued today during LPA's visit.

A copy of today's report was given to the Licensee, Devora Gonzalez Ortega. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Devora Gonzalez Ortega.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
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