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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004866
Report Date: 06/21/2024
Date Signed: 06/21/2024 10:10:29 AM


Document Has Been Signed on 06/21/2024 10:10 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:BRANNER, SHAMIKAFACILITY NUMBER:
384004866
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
06/21/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Shamika BrannerTIME COMPLETED:
10:30 AM
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On June 21, 2024 at approximately 9:30am, Licensing Program Analyst (LPA) Ly, conducted a follow up scheduled Pre-Licensing inspection and met with Applicant, Shamika Branner.

On June 11, 2024 during the pre-licensing visit, applicant was advised of the following corrections prior to licensure:

· Install earthquake proof straps for Television in the living room.
· Nap cots or mats for preschool age children.
· Firm mattress for playpen or crib for infant.
· Install gates for stairs: one to prevent children from going up alone, another to prevent children from coming down alone once finish using bathroom.
· Alarm for front door to prevent children from opening the door on their own or latch install above children's height so they can't open the front door.

During today's visit, LPA observed the following corrections:

·Earthquake proof straps have been installed to keep television from falling.
· A firm mattress has been added for play yard for napping infant.
·Gates have been installed at the top of the stair and at the bottom of the stair.
·Nap mats are available for children to take nap.
·Child proof door knob has been added to prevent children from opening the front door.

This report will be kept in the facility file and will be made available for public review upon request. Desk duty is available M-F, 8a.m.-5p.m., (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov

Small Family Child Care License is approved and will be effective as of today, 06/21/2024.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2024
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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