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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004738
Report Date: 12/19/2024
Date Signed: 12/19/2024 12:54:29 PM

Document Has Been Signed on 12/19/2024 12:54 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:MENDONCA, MAYRAFACILITY NUMBER:
384004738
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 3DATE:
12/19/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:47 AM
MET WITH:Mayra "May" MendocaTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On December 19, 2024 at approximately 9:47am, Licensing Program Analysts (LPAs) Catrina Quimbo and Jovanna Badger, conducted an unannounced, annual inspection. In conjunction with annual inspection, LPAs also conducted a case management visit for a large license.

LPAs met with licensee, Mayra "May" Mendoca, and explained the purpose of the visit. Present during LPAs' visit included licensee, licensee's assistant, and 3 children (2 preschool age and 1 infant). Licensee is operating within capacity limits during LPAs' visit. Licensee applied for a large capacity November 7, 2024. Fire inspection was conducted December 13, 2024.

Licensee lives in the home with their spouse and minor child. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are Monday through Friday 8:00am to 5:00pm.

The DAY CARE AREAS located on the ground level of the home is the backyard. Located on the second level of the home (main day care area) are the living room, dining area, kitchen, bathroom #1. The OFF LIMIT AREAS is the garage (pass by only to backyard), balcony (pass by only to backyard) and entire third level of the home. Bedroom #1 located on the third level of the home (napping room) was a previous day care area. Per fire department, with a large license, bedroom #1 can no longer be used as a day care area. There are multiple stairs in the home that have a child safety gate installed.

With licensee, LPAs inspected home for health and safety hazards. Licensee operates home as a Portuguese immersion program. LPAs observed day care areas to have a variety of toys and equipment that are in good condition. There is furniture for children's use that are age appropriate. LPAs observed home to be in good repair with proper temperature. There are a variety of materials and activities for children in good condition. Storage for children's belongings are located inside the home, labeled with children's individual names.

LPAs observed poisons, cleaning solutions and chemicals to be stored behind child safety locked cabinets or in home's high shelves. In kitchen, LPAs observed knives to also be stored in drawers that are also locked with child safety locks. LPAs observed all low cabinets in kitchen to have child safety locks installed.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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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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: MENDONCA, MAYRA
FACILITY NUMBER: 384004738
VISIT DATE: 12/19/2024
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LPAs observed home to include a fully charged fire extinguisher, fire alarm system, and smoke and carbon monoxide detectors. A carbon monoxide detector was tested during today's visit and was observed to be in working condition.

Children sleep in cribs. LPAs observed cribs to be free of loose articles and objects. LPAs did not observe materials to be hanging on the outside of the crib. Licensee provides tight fitting sheets for the cribs' mattresses that are laundered weekly or as needed. Licensee maintains sleeping logs for infants. LPAs observed sleeping logs document the time of when the napping infant is checked on every 15 minutes, any comments/observations of the infant while sleeping and the provider's name.

LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs 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.

Bathroom for children's use was observed to be in working condition. LPAs observed cabinets and drawers to bathroom to also have child safety locks installed. There is a diaper changing table in the home. Licensee provides diapers for children, that are appropriately labeled. LPAs observed a garbage bin with a tight fitting lid for dirty diapers to be disposed into.

Backyard is fully fenced and enclosed. Backyard includes a variety of outdoor toys and equipment. There is concrete in the backyard that is padded. Per licensee, backyard is not currently in use due to weather. LPAs did not observe any pools, spas or bodies of water on site.

Licensee provides a food service that includes breakfast, lunch and snacks. Reusable plates and utensils are utilized for children that are sanitized daily in home's dishwasher.

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/.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MENDONCA, MAYRA
FACILITY NUMBER: 384004738
VISIT DATE: 12/19/2024
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Licensee has licensing documentation properly posted and available for review. Licensee maintains a childcare roster that was made available for review. Disaster drills are conducted and properly documented. Last disaster drill was conducted 08/2024. Per licensee, there are no weapons or firearms in the home.

LPAs reviewed facility records that included six children's records, and assistant's record. Children's records are complete with emergency contact information. LPAs observed licensee has a current CPR/First Aid and Mandated Reporter certification. Assistant present also has proof of their immunizations and a current Mandated Reporter certification. LPA reminded licensee Mandated Reporter training must be renewed every two years by all staff working with children.

Capacity limits and ratios for a large family child care were reviewed and discussed with licensee on this date. Capacity limits and ratio sheets were provided during visit. LPA reminded licensee that when operating with more than 8 children, there must be a qualified assistant present. LPA reminded licensee that when no qualified assistant is present, licensee must operate within capacity limits of a small license.

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.

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, Mayra Mendoca, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Prior to approval for 14 children, fire clearance and landlord consent to be obtained.

No deficiencies were issued today during LPA'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, Mayra Mendoca.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
LIC809 (FAS) - (06/04)
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