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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004759
Report Date: 11/14/2024
Date Signed: 11/14/2024 03:51:01 PM

Document Has Been Signed on 11/14/2024 03:51 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:ALVES, JESSICAFACILITY NUMBER:
384004759
ADMINISTRATOR/
DIRECTOR:		ALVES, JESSICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(628) 241-5082
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
11/14/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:55 PM
MET WITH:Jessica Alves, Mayra PazTIME VISIT/
INSPECTION COMPLETED:
04:05 PM
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On 11/14/2024 at 2:55PM., Licensing Program Analyst (LPA) Luis Gomez and met with Assistant, Mayra Paz. The purpose of inspection was explained and was for an unannounced, plan of correction inspection established on 11/7/2024. Licensee, Jessica Alves arrived during inspection. Present was the licensee and 2 staff caring for 8 children. (6 preschool-age, 2 infant-age). Per licensee days and hours of operations are Monday- Friday, 7:00AM.- 7:00PM. Areas of the home designated for childcare are: (Upper Level): Living Room (Playroom); Dining Room (Activity Area); Bathroom #1, Outdoor Patio Area. Areas of the home designated as off-limit areas are (Upper Level): Kitchen (pass through only); Bedrooms 1#, #2, Entire Lower Level): Bedroom #3; Bathroom #2; Living room #2; Garage; and Lower Backyard. LPA inspected facility for health and safety hazards.

During inspection, LPA conducted record review, observation, and interviews.

LPA observed the following: Outdoor patio area has been set up for childcare with age-appropriate toys available for the children. Outside playthings inspected were in good repair. Area was free of hazards or dangerous conditions. Per licensee, outside patio area is utilized daily and cleaned prior to use.

Deficiencies issues on 11/7/2024 have been cleared, and 'letter of deficiency citation cleared' was provided.

Based on today's inspection, no deficiencies were observed in areas evaluated according to California Title 22, Div. 12 Chap. 3, Health and Safety, Code of Regulations. Exit interview was completed with Licensee, Jessica Alves. Licensee’s signature of this form acknowledges the 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, Mon-Fri, 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: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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