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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004141
Report Date: 07/26/2023
Date Signed: 07/26/2023 11:50:01 AM

Document Has Been Signed on 07/26/2023 11:50 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:CHAMORRO, CLAUDIA M.FACILITY NUMBER:
384004141
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 6TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
07/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Claudia M. ChamorroTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Yee conducted an Unannounced Required - 1 Year inspection today. The purpose of the visit was explained. LPA met with the licensee, Claudia, her helper, her daughter and 6 children (3 infants). LPA toured the home with the licensee. Current residents are the licensee, and her daughter. The facility personnel summary report was reviewed with the licensee. The licensee fingerprint clearance and her daughter fingerprint are not associated to this facility. The licensee did a name change and the daughter did a fingerprint clearance under a closed facility number. The licensee said they were unable to do a fingerprint clearance under this facility number. The licensee needs to follow up with the Guardian.

Daycare areas are: daycare room #1, bathroom, and kitchen. The remaining areas are off limit. For future, if any part of the daycare areas wishes to be added as part of the daycare areas, the licensee need to get an approval from the CCL department. The licensee said she understands. Licensee’s CPR, 1st aid expires 10/2024. Helper's CPR, 1st aid expires 09/2024.

LPA observed the home is clean orderly and properly ventilated. LPA also observed a 2A10BC Fire extinguisher, operable smoke detectors and carbon monoxide. There are no bodies of water in the home. Electrical outlets have child protective covers in place making them inaccessible to children. Chemical, detergents, cleaning compounds, medications, and other items of this nature are made inaccessible to children. Kitchen/Bathroom cabinets/drawers have child protective locks in place making all sharp objects or toxic house hold items inaccessible to children. First aid supplies are available for children. Facility last fire/earthquake drill was conducted on 04/27/23. Disciplinary policy was discussed with Licensee today. Home has age appropriate toys and equipment available for the children in care. The facility provides meals.

The children files were reviewed.

See next page.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2023
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: CHAMORRO, CLAUDIA M.
FACILITY NUMBER: 384004141
VISIT DATE: 07/26/2023
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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, before 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.

Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 the publication: Commonly Asked Questions about Child Care Centers
and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee was reminded about Mandated Reporter Training available on the CCLD website www.ccld.ca.gov
or www.mandatedreporterca.com). Licensee's AB1207 was completed on 2-8-23. The helper AB1207 was completed on 10-27-22.

LPA discussed the safe sleep regulations with the 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. 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. Infant sleep chart was provided.

>This report was translated into Spanish via Google translation and the licensee's daughter also helps with the translation. This report must be available in the facility for public review. Notice of site visit was given and must remain posted for 30 days.

Licensee was advised any additional questions to call Office, M-F, 8 am-5 pm, 650-266-8800 or
1-844-538-8766. Website: www.cdss.ca.gov
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC809 (FAS) - (06/04)
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