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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004457
Report Date: 03/18/2024
Date Signed: 03/18/2024 11:34:54 AM

Document Has Been Signed on 03/18/2024 11:34 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:MASSA, SHAYNA L.FACILITY NUMBER:
384004457
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
03/18/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Shayna Massa TIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Shayna Massa, and a helper who has fingerprint clearance. LPA explained the purpose of the inspection to her. There were 4 preschoolers with a helper present. The licensee rents and lives in this 3 stories single-family house with her husband, her son & daughter, and her boyfriend. The house has 7 bedrooms, 4 bathrooms, 3 kitchens, a living room, and a backyard. The daycare is located on the ground level. The daycare areas are the entire ground level and backyard. The off-limit areas are the entire first and second levels and a garage. The facility is called Shayna's Family Day Care Montessori Preschool and the operation hours are Monday to Thursday from 8:00 AM to 5:30 PM; Friday is from 8:00 AM to 4:00 PM. LPA inspected the areas for health and safety hazards. The facility was clean and in order, temperature and lighting were adequate and toxins and harmful objects were made inaccessible to the children. There was a fully charged 2A10BC fire extinguisher, working 2 1 smoke and carbon monoxide detectors, working cellular phone, and first aid supplies available in the daycare. There were plenty of age-appropriate toys, books, learning materials and equipment, and children's furniture that were in good condition and repair available indoors. Cribs, cots, and mats were used for napping. A diaper-changing table was available in the daycare areas. All the lower kitchen cabinets and drawers were either latched or free of harmful objects. The children's bathroom was clean. The lower bathroom sink cabinet and drawer were latched or free of harmful objects. The right amount of cubbies was available for children to store their personal belongings in the daycare areas. All electrical outlets had internal childproof blockage. All sharp corners were covered. The licensee installed carpets as soft cushioning to the floor in the rooms to prevent injury. The outdoor area is completely fenced. The licensee installed gates at the stairways. The licensee also installed the artificial Turf to the ground to prevent injury. There were plenty of age-appropriate outdoor toys, slide structures, sand/water tables, and ride-on toys available for the children. Per the licensee, there were 2 children on special medication. LPA inspected the storage of the medication and the medication itself. Per the licensee, she has no guns or weapons at home, but she has a dog which is vaccinated and is kept in an off-limit area. The licensee has provided AM/PM snacks and lunch to the daycare children. Per the licensee, she takes the children to the field whenever the weather is allowed. The facility conducts the disaster drill at least 2 times a year and logs. All required postings were posted. LPA reviewed the children's files and obtained a copy of the current children's roster during the inspection. The licensee had current CPR/First Aid Training that will expire in 5/2025. The facility had current Child Care Insurance that will expire on 8/18/2024.
continues in LIC809C
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2024
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 3
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: MASSA, SHAYNA L.
FACILITY NUMBER: 384004457
VISIT DATE: 03/18/2024
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Criminal Record Clearance - Licensee was reminded that all adults 18 and over living or working in home, 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 licensed Family Child Care Home. 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.

Safe Sleep - LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MASSA, SHAYNA L.
FACILITY NUMBER: 384004457
VISIT DATE: 03/18/2024
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MyChildCarePlan.org – Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law - During the exit interview, Shayna Massa, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the licensee, Shayna Massa.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024
LIC809 (FAS) - (06/04)
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