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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002760
Report Date: 02/13/2023
Date Signed: 02/13/2023 04:31:52 PM

Document Has Been Signed on 02/13/2023 04:31 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BUENA VISTA CHILD CARE, INC.(SA)FACILITY NUMBER:
384002760
ADMINISTRATOR:SCHLICKER, SHERIFACILITY TYPE:
840
ADDRESS:1266 FLORIDA STREETTELEPHONE:
(415) 283-5545
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 71DATE:
02/13/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Rochelle CeledonTIME COMPLETED:
04:35 PM
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On 2/13/2023 at 2:15PM., Licensing Program Analyst (LPA) Luis J. Gomez met with Director, Rochelle Celedon and Administrative Director, Judith Diaz. Purpose of the inspection was explained and was Unannounced: Case Management inspection to add four classrooms. Present is the director, Admin. Director and 17 staff supervising 71 children. Program offers after-school care St. Peter’s Catholic School. After-school program currently occupies three rooms: Parish Hall: Classroom #1, #2, #3, #4 the Library and one, shared, outdoor play yard, with a capacity of 90 children. Days and hours of operation are: Monday, Tuesday, Thursday, Friday: 3:00pm- 5:30pm, and Wednesdays, 12:30- 5:30pm. No changes have been made to current indoor and outdoor space. LPA inspected the facility inside and outside, with the director for health and safety hazards.

On 11/14/2022, program requested to add four classrooms: Main Building; Lower Level: #102, #110, and Upper Level: #205, #201.

LPA observed the following: Classrooms 102, 110, 205, 201 were orderly and equipped fully charged fire extinguishers (2A:10BC), and functioning smoke detectors. Carbon monoxide detectors were tested during inspection. Classrooms have cabinet space for children’s belongings. Classrooms have several child sized tables and chairs. Facility provides daily snacks and meals. Staff bathrooms is located separately. LPA observed drinking water is readily available indoors and outdoors. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2023
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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BUENA VISTA CHILD CARE, INC.(SA)
FACILITY NUMBER: 384002760
VISIT DATE: 02/13/2023
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Fire clearance approval was received on 1/25/2023.

During inspection, director submitted updated Facility Sketch (LIC999), Updated (LIC200A), Updated Emergency Disaster Plan (LIC610).

Prior to adding classrooms: #102, #110, #205, and 201 facility must:
-Post required forms including, Notice of Parent’s Rights (LIC995A), Emergency Disaster Plan (LIC610) in the classrooms.
-First aid kits available
-Prepare classrooms for after-school instruction.

>No deficiencies were cited against the facility under CCR, Title 22. 12 Ch. 3.

This report must be available in the facility for public review. Notice of site visit was observed being posted. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023
LIC809 (FAS) - (06/04)
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