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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410504500
Report Date: 01/17/2024
Date Signed: 01/17/2024 01:55:37 PM

Document Has Been Signed on 01/17/2024 01:55 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:CANESSA, ANGELAFACILITY NUMBER:
410504500
ADMINISTRATOR:CANESSA, ANGELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 325-8373
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 5DATE:
01/17/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Angela Canessa & Jeannie GallagherTIME COMPLETED:
02:45 PM
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On January 17, 2024 at approximately 1:25pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, plan of correction (POC) visit. LPA met with licensee, Angela Canessa, and explained the purpose of the inspection. Present in the home were licensee, licensee's helper (H1), and 5 enrolled children (3 infants and 2 preschool age).

On December 12, 2023 at approximately 2:20pm, LPA conducted an unannounced, annual inspection at facility. During annual inspection, LPA was issued two Type B citations for no staff on site having proof of a current CPR/First Aid certification and not maintaining sleeping logs for napping infants.

Facility closed 12/22/2023 through 1/3/2024 for holiday break. Facility reopened 1/4/2024. Facility also closed 1/15/2024 and reopened 1/16/2024.

During today's visit, LPA observed H1 to have a current CPR/First Aid certification, available for review. H1's CPR/First Aid certification will expire 10/2025. Per H1, licensee is scheduled to renew their CPR/First Aid certification by the end of January 2024. LPA reminded licensee and H1, no staff can be left alone with children without proof of a current CPR/First Aid certification.

On this date, there are 3 infants (I1, I2, I3) present. Per H1, I1 does not sleep while present in the licensee's home. Per H1, I2 has been travelling and has returned to licensee's home on today's date. Per H1, I3 is checked on while sleeping and the time of when I3 sleeps is documented.

LPA observed all cribs in napping room to be free of all loose articles and objects. Per H1, infants sleeping in the crib do not sleep with any blankets or toys. During visit, LPA provided a sample of sleeping log that should document the 15 minute time check of when napping infant is checked on. LPA reminded licensee and H1 sleeping logs must document every 15 minutes of when the infant is checked on and must be maintained for every infant under 24 months.

LPA observed notice of site visit to be properly posted and available for review in the home. Deficiency cited on December 12, 2023 has been cleared. LPA provided POC letter during visit. No deficiencies were cited during today'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 facility representative, Jeannie Gallagher.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2024
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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