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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000219
Report Date: 11/03/2025
Date Signed: 11/03/2025 12:34:23 PM

Document Has Been Signed on 11/03/2025 12:34 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:BENIFLAH, ANGELAFACILITY NUMBER:
384000219
ADMINISTRATOR/
DIRECTOR:		BENIFLAH, ANGELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 298-4273
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 12DATE:
11/03/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Angela BeniflahTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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On November 3, 2025, Licensing Program Analyst (LPA) Leong arrived at the facility to conduct an unannounced annual inspection. LPA presented his state-issued identification card to Licensee Angela Beniflah and explained the purpose of the inspection.

During the inspection, the licensee and three adult assistants were present in the home, caring for two infants and ten preschool-aged children. For today's inspection, the facility was observed to be within capacity limits and ratios.

Background check clearances have been granted by the California Department of Social Services (CDSS) for the licensee and three adults, authorizing their presence in the facility.

Hours of operation are Monday through Friday, 8:00 am to 5:00 pm. Licensing documents are posted on the bulletin board and available for review. Emergency disaster drills are conducted and documented. The last disaster drill was conducted on October 30, 2025.

Childcare areas are located on the ground level, including a playroom (behind the food preparation area), a play & project area (by the food preparation area), a nap room, a bathroom, and a backyard.

Off-limits areas are the entire second floor and the garage. The licensee understands that these off-limits areas may not be used for childcare during business hours.

LPA conducted a health and safety inspection of the designated child care areas. The environment was found to be clean, well-ventilated, and maintained at a comfortable temperature. Age-appropriate furniture, toys, and learning materials were readily available and in good condition. LPA observed that electrical outlets were secured with childproof covers. Hazardous items, including cleaning supplies and chemicals, were stored in areas inaccessible to children.

See Page 2

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Hanson Leong
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2025
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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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: BENIFLAH, ANGELA
FACILITY NUMBER: 384000219
VISIT DATE: 11/03/2025
NARRATIVE
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LPA observed that the home was equipped with a fire extinguisher, a first aid kit, multiple smoke detectors, and multiple carbon monoxide detectors. The bathroom was clean and contained age-appropriate toileting equipment,

The licensee confirmed that there are no firearms or other weapons stored or present on the premises.

LPA observed that the backyard is fully enclosed by a secure fence and is free of debris and hazardous materials. Outdoor play equipment is available for children's use and was observed to be in good working condition. No pools, spas, or other bodies of water were observed on the premises.

The licensee provides food service, including breakfast, lunch, and an afternoon snack. Water is refilled at the kitchen sink with a filter. Reusable dishes and materials are used and sanitized on-site daily. The licensee stated that no enrolled children currently have allergies. If a child were to have an allergy, the licensee indicated that medication would be stored in the bathroom cabinet, making it inaccessible to children.

LPA observed that the home is equipped with mats designated for children's napping. All sleep equipment appeared in good condition. The licensee stated that all bedding is laundered every week by the parents.

LPA reviewed facility records, including files for five enrolled children, the licensee, and her three assistants. Children's records were found to be complete and in compliance with licensing requirements. Infant sleep logs, which show the facility is checking infants, were not available for review. According to the licensee, she visually inspects the infants and does not document that they have been checked, resulting in a technical violation. A sample infant sleep log template was provided to the licensee during today's visit.

LPA verified that the licensee and her two adult assistants possess current certifications in Pediatric CPR and First Aid. Mandated Reporter Training certifications were reviewed and found to be either expired or incomplete. Therefore, the facility will receive a deficiency. TB test records were reviewed, and it was found that S2 did not have a copy of her TB test in her file, resulting in a technical violation.

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.

See Page 3

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Hanson Leong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025
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: BENIFLAH, ANGELA
FACILITY NUMBER: 384000219
VISIT DATE: 11/03/2025
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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/.

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.

Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.

Licensee was reminded that Pediatric CPR and First Aid, as well as Mandated Reporter Training, must be renewed every two years. Mandated Reporter Training may be taken at https://mandatedreporterca.com/. Pediatric CPR and First Aid training must be completed through a training program approved by the Emergency Medical Services Authority, the American Red Cross, or the American Heart Association.

During the exit interview, the LICENSEE, Angela Beniflah, 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.

Please refer to LIC 809D for today’s deficiency.

Appeal Rights were given to the licensee.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Angela Beniflah.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Hanson Leong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025
LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 11/03/2025 12:34 PM - It Cannot Be Edited


Created By: Hanson Leong On 11/03/2025 at 12:23 PM
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: BENIFLAH, ANGELA
FACILITY NUMBER: 384000219

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. The facility did not have current Mandated Reporter Training certificates in the staff files, which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/10/2025
Plan of Correction
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The licensee said that all staff, including herself, will complete the Mandated Reporter Training and submit it to LPA via email by the POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Garfield Leung
NAME OF LICENSING PROGRAM MANAGER:
Hanson Leong
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2025


LIC809 (FAS) - (06/04)
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