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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410507023
Report Date: 05/10/2024
Date Signed: 06/07/2024 03:12:55 PM

Document Has Been Signed on 06/07/2024 03:12 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:BOYD, SHERRI A.FACILITY NUMBER:
410507023
ADMINISTRATOR/
DIRECTOR:		BOYD, SHERRI A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 347-1934
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 2DATE:
05/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee, Boyd SherriTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On June 6, 2024 at approximately 1:00pm, Licensing Program Analyst (LPA) Melissa Zaragoza, conducted an unannounced, annual inspection. LPA was greeted and granted access by licensee, Boyd Sherri. At the entrance licensee was explained the purpose of the inspection. Present during LPA visit included Licensee, Licensee’s spouse, and 2 children (2 school age).

Hours of operation are Monday through Friday 7:30am to 5:30pm. Licensee lives in a one-level home with their spouse, and son. All adults living in the home, have fingerprint clearance on file.

The DAY CARE AREAS are the living room, kitchen, dining room, bathroom #1, bedroom #1, bedroom #2, bedroom #3 (not currently in use), bathroom #2 (currently not in use), and backyard. The OFF LIMIT AREAS are currently bedroom #3 and bathroom #2. All off limit areas made inaccessible with child safety gates.

LPA toured day care areas of home with licensee. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good condition. LPA observed electrical outlets to be made inaccessible with child safety covers. Cleaning supplies, poisons and hazardous materials are stored in home's high shelves and/or locked behind child safety locked cabinets.

Home is equipped with a fully charged fire extinguisher and smoke and carbon monoxide detectors. Smoke and carbon monoxide detectors were tested during visit and was observed to be in working condition.

Napping area (bedrooms) were observed to be equipped with a play pen and mats for when children sleep. Playpen were observed to be free of loose articles, bumper pads, and pillows. LPA observed playpen to have mattresses with tight fitting sheets. Per licensee, sheets are provided but, if child prefers a sheet from home, they are welcomed to bring it to FCCH for nap time. Per licensee, sheets are washed daily.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: BOYD, SHERRI A.
FACILITY NUMBER: 410507023
VISIT DATE: 05/10/2024
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Bathroom was observed to be in proper working condition. There is appropriate sanitation and toileting equipment for children in care. Per licensee, children’s families provide diapers and wipes for enrolled children.

Children eat in kitchen. A food service is provided to children that includes breakfast if needed, lunch and 2 snacks. LPA observed eating area to be clean and equipped with appropriate dining furniture. LPA observed knives to be made inaccessible. If a child is feeling sick the isolation areas are the bedroom.

Outdoor area is entirely enclosed and fenced. Outdoor area includes a variety of toys and equipment that were in good condition. Outdoor area has turf flooring, and shaded area for children when playing outside. LPA observed a Jacuzzi in the backyard area. Jacuzzi was locked and made inaccessible for children. Jacuzzi was tested by licensee, licensee sat on jacuzzi top cover. Per licensee, jacuzzi top cover can hold up to 300 pounds.

LPA reviewed 2 children's records which were complete. LPA reviewed licensee records which were complete. Licensee has a current CPR/First Aid certification and current Mandated Reporter certification. Licensee's CPR/First Aid certification will expire on 12/02/2025 and Mandated Reporter certification will expire 07/14/2026.

Emergency disaster drills are conducted and are appropriately documented. Last disaster drill was conducted 04/2024. LPA observed licensing documentation to be properly posted, made available for review. Facility maintains a childcare roster that was also made available for review.

Per licensee, there are weapons/firearms in the home. Licensee showed LPA the location of the home where firearm is stored. Firearm is made inaccessible to children in care and store in a locked safe. Safe was tested for opening and is secured and locked. Children cannot access safe.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries 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/inforesources/community-care-licensing/inspection-process.


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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024
LIC809 (FAS) - (06/04)
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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: BOYD, SHERRI A.
FACILITY NUMBER: 410507023
VISIT DATE: 05/10/2024
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record 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 the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing 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) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee, Boyd Sherri, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed a Megan’s Law search on 6/7/2024.

No deficiencies were issued 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 licensee, Boyd Sherri.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024
LIC809 (FAS) - (06/04)
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