384000813-4-11-2024-05-CC-CQUO-D48PGH-20240411111822

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000813
Report Date: 04/11/2024
Date Signed: 04/11/2024 11:18:27 AM

Document Has Been Signed on 04/11/2024 11:18 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:	GUERIN, DENISE MARIE		FACILITY NUMBER:	384000813
ADMINISTRATOR:	GUERIN, DENISE MARIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 821-7705
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 7	DATE:	04/11/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Denise Guerin		TIME COMPLETED:	11:30 AM

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 April 11, 2024 at approximately 8:30am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Denise Guerin, and explained the purpose of the inspection. Present during LPA's visit included licensee, licensee's assistant (A1), and 7 enrolled children (1 infant and 6 preschool age). Licensee is operating within capacity limits and ratio. Hours of operation are Monday through Thursday 8:00am to 5:00pm. Licensee lives in the home alone that consists of 3 bedrooms, 2 bathrooms, living room, kitchen and dining room. All adults living and/or working in the home have fingerprint clearance on file. The DAY CARE AREAS are living room, play room, hallway bathrooms (separate rooms for toilet and sink), kitchen and backyard. The OFF LIMIT AREAS are bedroom #1 (office), bedroom #2, dining room and entire upper level of home. Off limit areas are properly barricaded with child safety gates and/or locked doors. There are stairs to the backyard that also includes a child safety gate. LPA toured day care areas of home with licensee. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good working condition. LPA observed cleaning supplies, solutions and poisons are made inaccessible behind child safety locked cabinets and/or located in home's high shelves. The living room includes a fireplace that is properly barricaded and made inaccessible. Licensee has installed multiple gates around fireplace for additional safety. There are windows in living room that include a child safety lock. LPA observed knives in kitchen to be placed on a high shelf, inaccessible to children. Home is equipped with multiple fire extinguishers, a working smoke alarm system and a working carbon monoxide detector. LPA tested carbon monoxide detector during visit, which was observed to be working. Bathroom for children's use was observed to be in working condition and equipped with appropriate toileting equipment. LPA observed cabinets in bathroom to include child safety locks. LPA also observed garbage bin in bathroom to include a tight fitting lid. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GUERIN, DENISE MARIE	FACILITY NUMBER: 384000813
	VISIT DATE: 04/11/2024

NARRATIVE

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Children sleep in both the living room and playroom. Sleeping cots and portable cribs are utilized for napping children. During visit, LPA observed cots and portable cribs to be stored appropriately. Licensee provides napping children on cots with sheets and linens that are sanitized weekly or as needed. Licensee maintains a sleeping log for napping infants. LPA observed sleeping logs include the 15 minute time checks of when the infant is napping and the initials of the staff member checking on the napping infant. Per licensee, an assistant or licensee is always present with napping children.

Backyard is entirely enclosed and fenced. LPA did not observe any pools, spas or bodies of water in the backyard. Backyard is equipped with multiple outdoor toys and equipment that were in good condition. Children have access to a sink in the outdoor area that is equipped with appropriate sanitation materials. Flooring in backyard includes wood chips that was in good condition.

LPA reviewed seven children’s records. Children’s files have a record of emergency identification information on file. Licensee's Pediatric First Aid/CPR is current and will expire 08/2024. Staff working with licensee also have current First Aid/CPR certifications. Both licensee and staff working with licensee also have their required immunizations that were made available for review.

Licensee has licensing documentation properly posted and available for review. Licensee also maintains a child care roster that was made available for review. Emergency disaster drills are conducted at least once every six months and are properly logged. Last emergency disaster drill was conducted 1/30/2024. Per licensee, there are no weapons or firearms in the home.

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.
(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024

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: GUERIN, DENISE MARIE	FACILITY NUMBER: 384000813
	VISIT DATE: 04/11/2024

NARRATIVE

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

No deficiencies were issued today during LPA's visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Denise Guerin.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024

LIC809 (FAS) - (06/04)

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