<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002537
Report Date: 09/24/2024
Date Signed: 09/24/2024 11:41:19 AM

Document Has Been Signed on 09/24/2024 11:41 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:PINHEIRO, ALEXANDREFACILITY NUMBER:
384002537
ADMINISTRATOR/
DIRECTOR:		PINHEIRO, ALEXANDREFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 771-1004
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
09/24/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Alexandre PinheiroTIME VISIT/
INSPECTION COMPLETED:
11:50 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 9/24/2024 at 9:00PM., Licensing Program Analyst (LPA), Luis Gomez met with Licensee, Alexandre Pinheiro. This case management report is to cited facility for deficiencies observed during today's inspection. Present was the licensee, 2 staff caring for 9 children. (2 infant-age, 7 preschool-age) Facility was inspected for health and safety hazards.

At 10:25AM., Based on observation, LPA confirm child (C9) placed inside play pen during outside play time.
At 10:28AM., Based on observation, LPA confirmed wooden bench with sharp corners and splinters in backyard play area.

LPA reminded licensee to ensure baby bouncer is removed from facility. Advisory Note: Technical Violation (LIC9102TV) was issued.
LPA reminded licensee staff's files must be stored in the facility records. Advisory Note: Technical Violation (LIC9102) was issued.

During inspection, LPA provided licensee with LIC126, Records to be maintained in family childcare, and PIN 20-24 CCP.

Based on today's inspection, deficiencies were observed in areas evaluated according to California Title 22, Div. 12 Chap. 1, Health and Safety, Code of Regulations and cited on 809D. Exit interview, plans for correction, and report was reviewed with Licensee, Alexandre Pinheiro. Licensee's signature of this form acknowledges the receipt of these documents.

This report must be available in the facility for public review. Notice was given and must remain posted for 30 days. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2024
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 2
Document Has Been Signed on 09/24/2024 11:41 AM - It Cannot Be Edited


Created By: Luis Gomez On 09/24/2024 at 10:48 AM
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: PINHEIRO, ALEXANDRE
FACILITY NUMBER: 384002537

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2024
Section Cited
CCR
102425(e)

1
2
3
4
5
6
7
102425(e) Infant Safe Sleep: No infant shall be forced to sleep, to stay awake, or to stay in the designated sleeping area.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee will remove play pen from the backyard play area, and review safe sleep PIN 20:24CCP by the due date: 09/30/2024.

8
9
10
11
12
13
14
At 10:25AM., Based on observation, LPA confirm awake infant in care (C9) placed inside play pen during outside play. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Proof of correction will be submitted to the Department via email.
Type B
10/01/2024
Section Cited
CCR102417(g)

1
2
3
4
5
6
7
102417(g) Operation of Family Childcare: The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee will ensure accessible wooden bench is made safe for children in care by the due date: 10/1/2024.
8
9
10
11
12
13
14
At 10:28AM., Based on observation, LPA confirmed wooden bench with sharp corners and splinters in the backyard play area. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Proof of correction will be submitted to the Department via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Marie Rodriguez
LICENSING EVALUATOR NAME:Luis Gomez
LICENSING EVALUATOR SIGNATURE:
DATE: 09/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/24/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2