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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004876
Report Date: 02/27/2026
Date Signed: 02/27/2026 03:41:32 PM

Document Has Been Signed on 02/27/2026 03:41 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:GARCIA GUZMAN, MARIAFACILITY NUMBER:
384004876
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
02/27/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Maria Elena Garcia GuzmanTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On 2/27/2026 at 12:50PM., Licensing Program Analyst (LPA), Luis Gomez met with Licensee, Maria Elena Garcia Guzman. The purpose of the unannounced visit was explained and was Case Management inspected- licensee initiated, for Increase of Capacity, Room Addition/ Room Change. Per licensee, due to new physical plant changes, she is requesting to move childcare operation from the upper level to the lower level. Present was the licensee, licensee’s son, assistant caring for 6 children (4 preschool-age, 2 infant-age). The adults present have criminal record clearances on file. The licensee’s home has 3 bedroom, 3.5 bathroom, and is a 2-level house. The days and hours of operations are: Monday- Friday 8:00 AM.- 5:00 PM.
The requested areas designated for childcare are: Lower Level: Activity Room; Bathroom #1; and Backyard. The areas of the home designated as off-limits are: Upper Level: Living Room; Dining Room; Bedroom #1; #2; Kitchen; Bathroom #2; and Bathroom #3. Lower Level: Garage; and Bathroom #4. LPA inspected home, indoor and outdoor, with licensee for health and safety hazards.

At 1:00PM., LPA inspected the Lower Level: Activity Area; Bathroom #1; and Backyard. The area was observed clean and orderly with age-appropriate materials available for the children. The home’s floor and surfaces were clear of any obstructions or hazards. The accessible children’s furniture, playthings, books were in like-new condition. The furniture was free of sharp corners or splinters. The licensee has several child safety gates installed. To provide food services, LPA observed several wide- based feeding chairs with removable tables. The table with chairs were scaled to the proper size. For added storage/ materials, license has several cabinets available in sink area.

For scheduled rest/ nap, the home has several play pens and plastic mats stored in facility.
The home’s bathroom was maintained clean, and fixtures were in operating condition. The home was maintained at a comfortable temperature with ventilation and natural lighting. The off-limit areas have been made inaccessible with child safety gates and lockable doors. The licensee had functioning telephone service; carbon monoxide/ smoke detector combination detector; and fire extinguisher: 2A:10:BC.
(REFER TO 809C, FOR CONT)
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2026
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: GARCIA GUZMAN, MARIA
FACILITY NUMBER: 384004876
VISIT DATE: 02/27/2026
NARRATIVE
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LPA reviewed the backyard during visit. The area was completely enclosed with turf padding installed for added safety. The sandbox was free of hazardous objects. The LPA reminded licensee to remove accessible herbicidal sprays from backyard area. Item was removed during inspection. The home does not have any pool, fishponds, jacuzzi, or bodies of water.

LPA reviewed facility records including children’s files during inspection. The children’s files included the: Identification and Emergency Information (LIC700); Health History (LIC702); Consent for Medical Treatment (LIC627); Notification of Parent’s Rights (LIC995); and Immunization Records.

The licensee’s cardiopulmonary resuscitation/ first aid certification (CPR) was current, expiring: 7/2026.
The licensee’s ‘Mandated Reporter Training’ certification (AB1207) was current, expiring: 2/13/2028.
The facility conducts emergency disaster drill every 6 months, with last drill completed on 9/5/2025, properly logged.

Per licensee, isolation of an ill child is in the playroom. Per licensee, the guardians provide snack and lunch services for children in care.

During inspection, LPA offered to review the, the LIC311D, Records to Keep in Your Family Child Care Home, Children's Forms/ Records; Facility Forms/Records; and Information to be Posted with licensee. The licensee denied LPA request to review forms. The LPA and the licensee discussed licensing regulations and the capacity requirements. LPA advised licensee any children under 10 years of age will be counted in the total capacity. (REFER TO 809C, FOR CONT.)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC809 (FAS) - (06/04)
Page: 3 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: GARCIA GUZMAN, MARIA
FACILITY NUMBER: 384004876
VISIT DATE: 02/27/2026
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The licensee was reminded that all adults 18 years and over living in the home, person who provides care and supervision to children, and staff who have contact with children, including employee and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain criminal 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.

LPA discussed the safe sleep regulations with licensee, and discussed Child Care Licensing Safe Sleep Web page at:https://www.cdss.ca.gov/inforesource/child-care-licesning/public-information-and-resources/safe-sleep as an additional resource. LPA informed licensee of the importance of checking for recalled infant devices on United States consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The licensee was informed of the www.mychildcareplan.org site is a consumer education website that helps families obtain child care by connecting to child care providers and resources and referral agencies (R&R) throughout California.

The Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 20-02-CCP. When an IMS is provided, a plan for 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- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm (REFER TO 809C, FOR CONT.)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
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: GARCIA GUZMAN, MARIA
FACILITY NUMBER: 384004876
VISIT DATE: 02/27/2026
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To improve the overall quality and value of the new inspection process, a survey may be sent to the email address on file. Please complete our survey and share your inspection experience. If you have any questions regarding the process or tool, please send them 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/inforesource/community-care-licensing/inspection-process.

Prior to recommendation for Increase of Capacity and Room Addition/ Change, Licensee must complete the following:
-Receive Fire Clearance Approval (STD850)
-Remove cleaning detergents from bathroom areas
-Posting the required forms visible to Guardians (PUB379, LIC610A)

***No deficiencies were cited during this visit under Title 22, Division 12, Chap 3, of the Ca. Code of Regulations***

Exit interview, discussing LPA inspection report was conducted with licensee, Maria Elena Garcia Guzman. Licensee signature on this report acknowledges receipt of these documents.

This report must be available in the facility for public review. The notice was provided and shall remain posted for 30 days. The licensee was advised additional questions to call San Bruno Regional Office, M-F, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC809 (FAS) - (06/04)
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