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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505098
Report Date: 09/18/2024
Date Signed: 09/18/2024 11:06:06 AM

Document Has Been Signed on 09/18/2024 11:06 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:WESTRY, SUSANFACILITY NUMBER:
380505098
ADMINISTRATOR/
DIRECTOR:		WESTRY, SUSANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 874-9745
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY: 12TOTAL ENROLLED CHILDREN: 2CENSUS: 2DATE:
09/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Licensee, Susan WestryTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
NARRATIVE
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On 9/18/2024, at approximately 9:15AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Licensee, Susan Westry (L1), and explained the purpose of the visit. Present during the visit was Licensee, two resident adults, one school-age child, and one infant. The facility is in compliance with staffing and ratio requirements on this day. The facility’s operating hours are from 7:30AM to 6:00PM, Monday to Friday.

Daycare Areas: Living Room, Dining Area, Kitchen, and the Children’s Room.
Off-limits Areas: Entirety of the Second Floor and the Garage.

LPA and L1 inspected the facility for any health or safety hazards. LPA observed the home to be in clean and orderly condition. There is a fully charged 2A10BC fire extinguisher present in the Kitchen. There is a carbon monoxide detector present in the Children’s Room. Stairs leading to the first floor are barricaded and inaccessible. LPA observed that stairs leading to the second floor did not have a barricade or gate installed. L1 stated that the previous gate was broken and that a new one was being delivered. LPA requested that a photo of the new gate be sent via email once it is installed. L1 stated that they understood and agreed. LPA observed that the cabinet underneath the Kitchen sink was not secured with a functioning childproof lock. L1 stated that they would install a functioning lock.

LPA observed there to be age-appropriate toys and learning materials for children in care. Furniture is age-appropriate and free of rough or sharp edges. L1 stated that they provide all meals for children in care (breakfast, lunch, and snacks). Children nap on cots or in pack-and-plays as needed. LPA discussed the use of cots or mats for sleeping children. Children bring blankets and bedding from home and take it home once a week for cleaning. Per L1, bedding is also cleaned at the facility as needed.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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 5
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: WESTRY, SUSAN
FACILITY NUMBER: 380505098
VISIT DATE: 09/18/2024
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There is no fenced outdoor play area at the facility. Per L1, children are taken to a nearby park to play. The park is within walking distance of the facility. The facility provides supervision for children during outdoor play. There are no pools or other similar bodies of water present in the facility. Per L1, there are no firearms or weapons in the home.

LPA reviewed Licensee’s file, two children’s files, and facility records. Licensee’s Pediatric First Aid/CPR certificate expires 7/2025. Licensee’s Mandated Reporter Training expires 12/2025. Immunization records are available for review. LPA observed the two children’s files to be complete. LPA reviewed the facility’s enrollment packet and observed it to contain all required licensing paperwork and forms. All required postings are posted and accessible for review in the Children’s Room.

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.

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.

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.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WESTRY, SUSAN
FACILITY NUMBER: 380505098
VISIT DATE: 09/18/2024
NARRATIVE
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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/.

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, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

See LIC9102-TV for technical violations issued today regarding inaccessible chemicals and stairs.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Susan Westry.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
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