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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002054
Report Date: 07/05/2023
Date Signed: 07/05/2023 10:05:20 AM

Document Has Been Signed on 07/05/2023 10:05 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LEON-ALCAZAR, REBECAFACILITY NUMBER:
384002054
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
07/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Rebeca Leon-AlcazarTIME COMPLETED:
10:20 AM
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On July 5, 2023, at 8:00AM., Licensing Program Analyst (LPA) Maria Olguin-Leon met with licensee, Rebeca Leon-Alcazar, for unannounced annual inspection. The purpose of the inspection was explained. Present for today’s were Licensee, assistant, and 3 children (2 infants and 1 preschooler). Licensee own a puppy, Puppy stays in off limits area during daycare hours. All adults have fingerprint clearance. Licensee operates Mon-Fri. 8:00-5:15 PM.

Licensee and LPA toured home for health and safety hazards. Licensee rents 2-bedroom apartment. Apartment is located on second floor Day Care Areas: Living room, Kitchen/dining area. Off limit areas: Bedroom #1 and bedroom #2 and bathroom. Licensee takes children to Mission Playground on 19th & Valencia St. Hallway to off limits area is properly barricaded with a child proof fence. Kitchen cabinets have child protective locks in place. The house is in good repair and free of hazards with proper temperature and ventilation. Home has age- appropriate toys, books, furnishing and playpens. Living room is equipped with foam rugs to cushion falls. Fireplace is properly barricaded. Windows are barricaded with child proof gates. All the cleaning supplies, poisons and other chemicals are stored inaccessible to the children.
Per licensee, there is no firearm or weapon in the house.

Home is equipped with a working dual carbon monoxide/smoke detector and a fully charged fire extinguisher. First aid kit is full of supplies. Licensee uses cell phone and understands phone is to be always kept on premises. Licensee will complete Mandated Reporter training and submit certificate to LPA, technical assistance issued. CPR/First Aid is current and expires 10/2024. Last emergency drill conducted 09/2022, LPA reminded Licensee emergency drill must be conducted and documented every 6 months, technical violation issued. LPA reviewed three children records and all documents were available, including LIC282. Licensee has all the required documents posted and are visible for the public. Children’s roster was reviewed and up to date. LPA was reminded to keep a current file for all assistance, technical assistance was issued.
Cont. page 2...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 07/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/05/2023
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 7
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: LEON-ALCAZAR, REBECA
FACILITY NUMBER: 384002054
VISIT DATE: 07/05/2023
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Safe Sleep
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-and-resources/safe-sleep as an additional resources. LPA discussed keeping sleep logs for children under 2 yrs. old., sleep sacks and safe sleep plan.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and
volunteers, 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 up to $500.00 maximum per day/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-and-resources/safe-sleep as an additional resource.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Where 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 and Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA also informed the 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.

Cont. page 3...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2023
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: LEON-ALCAZAR, REBECA
FACILITY NUMBER: 384002054
VISIT DATE: 07/05/2023
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The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. 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.

LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations
and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be
added to the email list for the updates.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting
requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Rebeca Leon-Alcazar.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2023
LIC809 (FAS) - (06/04)
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