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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004346
Report Date: 06/29/2023
Date Signed: 06/29/2023 03:37:35 PM

Document Has Been Signed on 06/29/2023 03:37 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ACEVES, ROSAURAFACILITY NUMBER:
384004346
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
06/29/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Rosaura AcevesTIME COMPLETED:
04:00 PM
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Licensing Program Analysts (LPA) Yee conducted a case management inspection today. The facility requested an increase in capacity for a large FCCH. LPA and Licensee toured the daycare areas. This is a single-family home. Present at the facility are the licensee, Rosaura Aceves, helper/daughter, 2 daycare children. The facility personnel summary report was reviewed with Rosaura and she said it is current. All adults living or working in the home have criminal background checks on file. Current residents at the facility are Rosaura, her husband and Rosaura's son. The licensee son just turned 18 and the licensee said he will get the fingerprint done ASAP.

Day Care Areas: living room, dining room, hallway bathroom, and back yard. The remaining areas are off limit.

Fire Clearance was approved on 06/12/2023.

A capacity worksheet for large FCCH was explained and provided.

LPA will recommend a large license effective today.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2023
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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