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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002760
Report Date: 12/16/2025
Date Signed: 12/16/2025 05:47:49 PM

Document Has Been Signed on 12/16/2025 05:47 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:BUENA VISTA CHILD CARE, INC.(SA)FACILITY NUMBER:
384002760
ADMINISTRATOR/
DIRECTOR:		SCHLICKER, SHERIFACILITY TYPE:
840
ADDRESS:1266 FLORIDA STREETTELEPHONE:
(415) 283-5545
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 200TOTAL ENROLLED CHILDREN: 200CENSUS: 73DATE:
12/16/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Rochelle Celedon, Judith Garcia TIME VISIT/
INSPECTION COMPLETED:
06:00 PM
NARRATIVE
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On 12/16/2025 at 1:50PM., Licensing Program Analyst, Luis Gomez met with Program Director, Rochelle Celedon. The purpose of the visit was explained and is for an unannounced; annual random inspection. The program offers after-school care, which operates at St. Peter’s Catholic School. The program is using Parish Hall: Lower Level, Middle School Room; Main Building: Classrooms #110, #102, # 201, and 20. Program also has a shared, Library and Outdoor Play Yard. Per director, classroom #4, and 205 are not in use. Per director, days and hours of operation: Tuesday, Wednesday, Thursday, Friday: 3:00pm- 5:30pm and Mondays, 12:30- 5:30pm. Present were the director, and 13 staff supervising 73 children. LPA inspected the facility, indoor and outdoor, with director for health and safety hazards.

At 2:20PM., LPA observed the following: The classrooms were maintained clean and neat. Facility furniture, cubbies, and materials inspected were in good repair. Each classroom was equipped with tables and chairs for activities. The classrooms have acceptable ventilation and lighting. The facility has functioning carbon monoxide detector; smoke detector (Built-in), and fully charged fire extinguishers (2A10BC).

LPA reminded director to ensure large television is properly anchored inside classroom #102. Advisory Note: Technical Violation (LIC9102TV) was issued.

The food storage area/ kitchen was reviewed during inspection. The food items inspected were current and had been properly stored. Per director, food service are provided by 3rd party (Chefables), and is delivered daily.

LPA reminded director, cleaning supplies/ detergents must be stored separately from food items. During inspection, director moved cleaning supplies to an off-limit cabinet, located away from food storage area. Advisory Note: Technical Violation (LIC9102TV) was issued.

LPA inspected the outdoor play areas and children’s bathrooms. The area was enclosed and was free of trash or rubbish, with plaything in good repair. The drinking water is available for the children with use of water station and refillable bottle. The bathrooms had adequate supplies for handwashing. (REFER TO 809C, FOR CONT.)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2025
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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Document Has Been Signed on 12/16/2025 05:47 PM - It Cannot Be Edited


Created By: Luis Gomez On 12/16/2025 at 04:56 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: BUENA VISTA CHILD CARE, INC.(SA)
FACILITY NUMBER: 384002760

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 4:15PM., Based on record review, LPA confirmed staffs proof of immunization are missing from the facility files. This poses a potential risk to the health and safety children in care.
POC Due Date: 01/05/2026
Plan of Correction
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Director will collect and store, the staff's proof of immunization by the due date: 1/5/2025.
Proof of correction will be submitted to the Department via email.
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.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Luis Gomez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2025


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: BUENA VISTA CHILD CARE, INC.(SA)
FACILITY NUMBER: 384002760
VISIT DATE: 12/16/2025
NARRATIVE
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(Page 2)
At 3:30PM., LPA review facility records including sample of 4 children’s files and 13 personnel files. The staff files reviewed and included: Declaration to Report Suspected Child Abuse (LIC9108); Proof of Teacher Qualifications; and Notice of Employee Right (LIC9052).

At 4:15PM., Based on record review, LPA confirmed staffs proof of immunization are missing from the facility files.

LPA reminded director to ensure staff renew required mandated reporter training course (AB1207). Advisory Note: Technical Violation (LIC9102TV) was issued.

The children’s files were reviewed included: Identification of Emergency Information for each child.
LPA reminded director to ensure the signed admission agreement, consent for medical treatment, notification of parents rights, and personal rights forms is stored in the children's files. Advisory Note: Technical Violation (LIC9102TV) was issued.
Present staff members had their current CPR/ 1st aid certification on file.
Per director, facility is conducting emergency disaster (Earthquake and Fire drills) every six months, with last on done one on 7/10/2025, properly logged.

Assembly Bill (AB) 2370, chapter 676, statues 2018 requires all licensed child care centers (CCC’s) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and every five years after the date of the first test.
LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN21-21- CCP.

All required posting were reviewed including the facility included the License, Parents Rights (PUB393), Emergency Disaster Plan (LIC610). LPA reminded Director to post snack/ lunch menu in visible location for families, a least a week in advance.

For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. (REFER TO 809C, FOR CONT.)
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC809 (FAS) - (06/04)
Page: 9 of 9
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: BUENA VISTA CHILD CARE, INC.(SA)
FACILITY NUMBER: 384002760
VISIT DATE: 12/16/2025
NARRATIVE
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The director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 Child Care Center. 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations, and cited on LIC809D.
An exit interview discussing the facility evaluation report and plan of correction was conducted with Director, Michelle Celedon, and signature on this form acknowledges the receipt of these documents.

This report must be made available in facility for public review. Notice of site visit was provided and must remain posted for 30 days. Director was advised, any additional questions/ concerns to contact the San Bruno Regional Office, Mon-Fri, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC809 (FAS) - (06/04)
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