384004699-12-17-2025-05-CC-CQUO-DPFVG3-20251217152453

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004699
Report Date: 12/17/2025
Date Signed: 12/17/2025 03:25:04 PM

Document Has Been Signed on 12/17/2025 03:25 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:	RODRIGUEZ AGUILAR, JASMINE		FACILITY NUMBER:	384004699
ADMINISTRATOR/ DIRECTOR:	RODRIGUEZ AGUILAR, JASMINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 713-6098
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94132
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 9	CENSUS: 4	DATE:	12/17/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:10 PM
MET WITH:	Jasmine Rodriguez Aguilar		TIME VISIT/ INSPECTION COMPLETED:	04:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On December 17, 2025 at approximately 1:10pm, Licensing Program Analyst (LPA) Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Jasmine Rodriguez Aguilar, and explained the purpose of the visit. Upon LPA's arrival, children were sleeping. Present during LPA's visit included licensee, licensee's assistant, and 4 enrolled children (1 infant and 3 preschool age children). Licensee is operating within capacity limits and ratio during LPA's visit. Licensee lives in the home with their fiance. Licensee, their fiance and assistant have fingerprint clearance on file. The home is multi-level home with separate units. Licensee lives and operates their family childcare program on the second level of the home only. Hours of operation are Monday through Friday 7:30am to 5:00pm. The DAY CARE AREAS are the dining area (main day care area), hallway bathroom and bedroom #1. The OFF LIMIT AREAS are kitchen (pass by only), living room (area with fireplace), master bedroom, and entire ground level of home. LPA observed the off limit areas to be made inaccessible with a child safety gate and/or closed doors with child safety door handles. The fireplace is made inaccessible to children with the child safety gate and child safety lock. There are also stairs in the home that lead to the ground level of the home. Stairs are made inaccessible with a locked door that also includes a child safety door handle. With licensee, LPA inspected day care areas for health and safety hazards. LPA observed day care areas to be clean and organized. There are shelves and book cases in the day care areas that include padding on its corners. Furniture, toys and materials are age appropriate and in good condition. Per licensee, toys and materials are hand washed weekly for cleaning. Day care areas include rugs and soft padding that are clean, free of stains, and in good condition. Per licensee, rugs are laundered weekly while soft padding is wiped daily. (Continue report on page 2...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: RODRIGUEZ AGUILAR, JASMINE	FACILITY NUMBER: 384004699
	VISIT DATE: 12/17/2025

NARRATIVE

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LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers. There are cubby shelves in the kitchen for children's personal belongings to be stored. LPA observed cubbies to be labeled with children's individual names. There is a window in the day care area that was observed to be closed and barricaded with a gate. Per licensee, window is not opened during day care hours. There are closets in the day care areas that were observed to be made inaccessible with child safety locks.

Home is equipped with a fire extinguisher, first aid kit, and smoke and carbon monoxide detectors. LPA tested carbon monoxide detector during today's visit, which was observed to be working. Both earthquake and fire drills are conducted monthly. LPA observed disaster drills to be documented and maintained. LPA reviewed disaster drills for 2025 year and 2024 year. Last documented disaster drill was conducted 12/12/2025.

Licensee provides a food service that includes breakfast, lunch and snack. Licensee utilizes reusable plates and utensils that are hand washed daily. Children eat in the dining area. Tables and chairs for children's use are age appropriate. Per licensee, no currently enrolled children have allergies. Food is prepared in the kitchen. LPA observed knives to be stored in a child safety locked drawer, inaccessible to children. LPA also observed cleaning solutions to be stored behind a child safety locked cabinet, separate from where food is prepared.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/

Bathroom for children's use was observed to be clean and equipped with age appropriate toileting equipment LPA observed bathroom to be in working condition. LPA also observed cabinets, drawers, and shower to have child safety locks installed. There are diapering children enrolled in care. LPA observed a diaper changing table in the home. Diapers and wipes are provided by children's families. LPA observed diapers and wipes to be stored appropriately, labeled with children's individual names. There is a garbage bin with a tight fitting lid to dispose of dirty diapers.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2025

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: RODRIGUEZ AGUILAR, JASMINE	FACILITY NUMBER: 384004699
	VISIT DATE: 12/17/2025

NARRATIVE

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Children sleep in bedroom #1. LPA observed children present to be sleeping on floor mats. Sheets and blankets are provided by families and are laundered weekly. There is a crib in bedroom #1 for an infant (whom was not present during visit). LPA observed crib to be free of loose articles and objects. Placement of crib does not hinder the entrance or exit to the room. Licensee maintains sleeping logs for infants. LPA reviewed random sleeping logs from December 2023, February 2024, March 2024, June 2025, November 2025 and December 2025. LPA observed licensee to maintain two sleeping log versions. One version documents the date, the time the infant fell asleep, the napping infant's sleeping position, the 15 minute time stamp of when the infant is checked on, and the initials of the individual checking on the infant. Another sleeping log version documents the date, the 15 minute time stamp of when the infant is checked on and their sleeping position.

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 and removing any 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.

Backyard is fenced. Backyard is not a day care area nor does licensee have access to backyard. LPA was unable to inspect backyard during today's visit.

LPA reviewed facility records that included 6 random children's records, licensee's record, licensee's assistant's record, and licensing documentation. LPA observed licensing documentation to be properly posted, available for review. Licensee maintains a childcare roster that was made available for LPA's review. Children's records are complete with emergency information and immunizations. LPA observed infants' records to include a Needs and Services plan as well as the Infant's Individual Sleeping Plan (LIC9227).

Licensee and assistant's records are also complete. Required immunizations for licensee and assistant were made available for review. Both licensee and assistant have a current Mandated Reporter certification that was made available for review. Both licensee and assistant also have a current CPR and First Aid certification that will expire 3/2027. There is a pet in the home that is kept in the off limit bedroom. Per licensee, there are no weapons or firearms in the home.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: RODRIGUEZ AGUILAR, JASMINE	FACILITY NUMBER: 384004699
	VISIT DATE: 12/17/2025

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the 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.

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.

During the exit interview, the Licensee Jasmine Rodriguez Aguilar, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

No deficiencies were issued during today's visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Jasmine Rodriguez Aguilar.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2025

LIC809 (FAS) - (06/04)

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