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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004525
Report Date: 08/14/2023
Date Signed: 08/14/2023 02:11:42 PM

Document Has Been Signed on 08/14/2023 02:11 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:SWEET PEAS TOOFACILITY NUMBER:
384004525
ADMINISTRATOR:DIONNE, SAMANTHAFACILITY TYPE:
830
ADDRESS:2730 17TH STREETTELEPHONE:
(415) 701-0495
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 25DATE:
08/14/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Annette MedranoTIME COMPLETED:
02:15 PM
NARRATIVE
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On 8/14/2023 at 12:15PM., Licensing Program Analyst (LPA) Luis J. Gomez met with Assistant Director, Anette Medrano. Purpose of the inspection was explained and was for an unannounced; Plan of Correction inspection. Present was the assistant director and 6 staff caring 25 children. LPA inspected facility with licensee, for health and safety hazards.

During today’s inspection, LPA performed observations, record review and interviews.

At 1:00PM., LPA observed the following: facility’s toddler/ infant classrooms are made separate, with no co-mingling possible between groups.

On 7/14/2023, Assistant director submitted an updated schedule to the department via email.

Deficiency issued on 7/7/2023, have been cleared and ‘Cleared Plan of Correction Letters’ were provided.

Exit interview, plan of correction, and report was discussed with Assistant Director, Anette Medrano, and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and shall remain posted for 30 days. Licensee was advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2023
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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