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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004836
Report Date: 02/14/2024
Date Signed: 02/14/2024 10:25:53 AM

Document Has Been Signed on 02/14/2024 10:25 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:GONZALEZ, HASSELFACILITY NUMBER:
384004836
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/14/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Hassel GonzalezTIME COMPLETED:
10:39 AM
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On February 14, 2024 at 8:20 AM, Licensing Program Analyst (LPA) Nasiripour met with applicant, Hassel Gonzalez, for an announced Subsequent Pre-Licensing Inspection. Present in the home are applicant and her adult daughter, Kelly Aguilar, who is also an aide to the Family Child Care Home.

Per the initial Pre-Licensing Inspection on February 6, 2024, applicant communicated that they had not moved in to the home, and was required to install childproof locks on all kitchen drawers, the refrigerator, and oven. Additionally, the applicant was required to install childproof locks on the toilet seat and bathroom drawers, as well as a child safety gate in the outdoor play area walkway leading to the exit gate.

LPA confirmed that all requirements have been met on this subsequent visit and observed that the applicant has personal belongings in the bedrooms, closets, kitchen, and bathrooms.

During the Subsequent Pre-Licensing Inspection, applicant had communicated that they had rearranged the daycare items and had added new fixtures and equipment in the home. As a result, LPA had conducted an additional inspection of the home and daycare areas. The new fixtures and items added to the daycare areas were one 4' tall bookshelf that has been securely mounted to the wall, two 2' tall sensory tables, one sand table, and one round table for children to conduct their lessons.

LPA confirmed that all adults living in the home have received their fingerprint clearance.

LPA will recommend the applicant for a Large Family Child Care Home license. License will take affect on February 14, 2024.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Yasha Nasiripour
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2024
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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