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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004316
Report Date: 09/15/2022
Date Signed: 09/15/2022 10:13:19 AM

Document Has Been Signed on 09/15/2022 10:13 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BAQUERO, ANGELA V.FACILITY NUMBER:
384004316
ADMINISTRATOR:BAQUERO, ANGELA V.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 754-3380
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
09/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Angela V. BaqueroTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Yee conducted a required - 1-year inspection today. Present at the facility are the licensee, Angela, the helper, and 3 daycare children. The purpose of the inspection was explained. Days and hours of operation: Monday-Friday 7:30 AM-6:00 PM. Current residents are Angela, her husband, Jose's 16 years old son, and their 2 years old daughter.LPA Yee and the licensee did a physical plant tour to inspect for health and safety hazards in the licensed areas. The facility is equipped with a fully charged fire extinguisher that meets the minimum requirements, smoke detectors, and a carbon monoxide (CO) detector in the daycare. First aid supplies are available. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored inaccessible to children. The daycare area is clean and orderly. LPA did not observe any spas, swimming pools, hot tubs, fish ponds, or similar bodies of water in the home. There are plenty of age-appropriate toys and materials available in the daycare areas. Licensee and helper have current Pediatric First Aid and CPR training (exp. 3-12-24). The roster was reviewed. Licensee and helper have mandated child abuse reporter training certificate, AB1207 on file. One child arrived during the inspection.

LPA 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.

Incidental Medical Services (IMS) policy discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is 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 about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The facility informed that effective September 1, 2016, a person may not be employed or volunteer at a child care 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.

This report is reviewed with a facility representative and a copy of this report must be made available for public review upon request.

Notice of Site Visit posted and shall remain posted for 30 days.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2022
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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