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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380506144
Report Date: 01/14/2025
Date Signed: 01/14/2025 10:53:07 AM

Document Has Been Signed on 01/14/2025 10:53 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:JENKINS, CAROLFACILITY NUMBER:
380506144
ADMINISTRATOR/
DIRECTOR:		JENKINS, CAROL A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 554-0559
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94117
CAPACITY: 12TOTAL ENROLLED CHILDREN: 1CENSUS: 1DATE:
01/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Licensee, Carol JenkinsTIME VISIT/
INSPECTION COMPLETED:
11:05 AM
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On 1/14/2025, at approximately 9:10AM, Licensing Program Analyst (LPA) Jonathan Tse arrived at the facility to conduct an unannounced annual visit. LPA met with Licensee, Carol Jenkins and explained the purpose of the visit. Present during the visit was Licensee and one infant. The facility is operating within staffing and ratio requirements on this day.

Daycare Areas: Living Room and Half-Bathroom located on the ground level.
Off-limits Areas: Entire upper levels. Bedroom, Kitchen, Bathroom and Garage in the ground level.

LPA and Licensee inspected the facility for any health or safety hazards. The facility is equipped with a fully charged 2A10BC fire extinguisher. Licensee demonstrated a carbon monoxide detector to be operational during the visit. There is a fireplace present in the Living Room that has been blocked off with furniture. Electrical outlets are covered or blocked with furniture when not in use. Stairs are rendered inaccessible to children in care with barricades. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children. The home was observed to be in clean and orderly condition. LPA verified the facility’s primary phone number with Licensee during the visit.

LPA observed there to be age-appropriate toys and learning materials in the home. Furniture was observed to be free of rough or sharp edges. Per Licensee, children nap on mats that are cleaned daily. Bedding is brought from home and kept at the facility. LPA observed there to be extra diapers kept in the facility. LPA discussed the use of sleep sacks with Licensee. Sleep sacks are considered to be swaddling devices and as such are not allowed to be used in a licensed childcare facility. Licensee stated that they understood. The facility provides lunch and AM/PM snacks for children in care. There are no children with food allergies currently enrolled.


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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: JENKINS, CAROL
FACILITY NUMBER: 380506144
VISIT DATE: 01/14/2025
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There is no outdoor play area located in the facility. Per Licensee, children are taken on neighborhood walks to nearby parks or libraries. There are no swimming pools or other similar bodies of water present in the facility. There is a pet dog in the home. Per Licensee, children do not play with the dog. There are no firearms or weapons stored in the home.

LPA reviewed Licensee’s file, one child’s file, and facility records. Licensee’s immunization record was made available for review during the visit. LPA advised that Pediatric First Aid/CPR training and Mandated Reporter Training must be completed every two years. Licensee stated that they understood. LPA observed the child’s file to be complete. The facility last conducted an emergency drill in 12/2024. Drills are logged and documented. The facility roster was available for review. All required postings were observed to be posted and accessible for review.

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.







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

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: JENKINS, CAROL
FACILITY NUMBER: 380506144
VISIT DATE: 01/14/2025
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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.

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.

No deficiencies were cited during today’s visit on 1/14/2025. A notice of site visit was given and must remain posted for 30 days.

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

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC809 (FAS) - (06/04)
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