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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001628
Report Date: 08/18/2026
Date Signed: 08/18/2026 03:09:13 PM

Document Has Been Signed on 08/18/2026 03:09 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:ORILLE, NANCY CANOFACILITY NUMBER:
414001628
ADMINISTRATOR/
DIRECTOR:		ORILLE, NANCY CANOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 995-4932
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
08/18/2026
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Nancy Cano OrilleTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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On August 18, 2026, Licensing Program Analysts (LPAs) Van and Cruz arrived at the family child care home to conduct an unannounced Plan of Correction (POC) inspection. LPAs met with the licensee, Nancy Cano Orille, and explained the purpose of the visit. The licensee granted LPAs access to the home. Upon entry, the licensee was supervising 3 children in care.

During the July 14, 2026, annual inspection, LPAs cited deficiencies related to record keeping. Deficiencies included missing documentation of fire and earthquake drills; multiple infants missing the required 15-minute sleep log entries; missing licensee immunization records (Measles/MMR, Tdap, Influenza); and the TB clearance was not available for review. LPAs also confirmed that all children present had immunization records or PM 286 forms available for review. Additionally, one infant under 12 months did not have an Individual Infant Sleeping Plan (LIC 9227).

Technical violations were also issued for a Pack n’ Play with a loose bedsheet, another Pack n’ Play containing a bassinet attachment, a mandated reporter training certificate that was not available for review, and a carbon monoxide detector that was not installed or plugged in.

During today’s visit, LPAs reviewed all deficiencies and technical violations previously issued. Based on the review, LPAs found that the required drill records were available; infant sleep logs were updated and maintained at 15-minute intervals; the licensee provided complete immunization documentation; and the missing LIC 9227 was completed.


Continued on page 2.
Garfield Leung
Brendon Van
DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2026
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: ORILLE, NANCY CANO
FACILITY NUMBER: 414001628
VISIT DATE: 08/18/2026
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page 2.
However, the TB clearance was not available for review during today’s visit, resulting in the licensee failing to correct this deficiency. A civil penalty was assessed today. LPAs confirmed that Pack n’ Plays were safe and compliant, the mandated reporter certificate was available, and the carbon monoxide detector was properly installed. However, the carbon monoxide detector was observed chirping periodically. The licensee stated the battery had been replaced.

Based on today’s inspection, all deficiencies and technical violations cited on July 14, 2026, have been corrected except for the TB clearance, which remains outstanding.

See LIC809D for deficiency cited today.

A Notice of Site Visit was issued and must remain posted for 30 consecutive days.

An exit interview was conducted, the report and appeal rights were reviewed with the licensee, Nancy Cano Orille.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 08/18/2026 03:09 PM - It Cannot Be Edited


Created By: Brendon Van On 08/18/2026 at 02:36 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ORILLE, NANCY CANO
FACILITY NUMBER: 414001628

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/28/2026
Section Cited
CCR
102369(b)(9)

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102369 Application for Initial License (b) (9)Evidence of a current tuberculosis clearance,... in the home during the time that children are under care.

This requirement was not met as evidenced by:
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The licensee stated she will obtain and maintain complete immunization records and tuberculosis clearances for herself. The licensee will ensure that all required documentation is kept in the facility’s personnel files and made available for review during inspections. A return visit will be conducted to verify compliance.
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Based on the records review, the licensee did not comply with the cited regulation in that the tuberculosis clearance was missing from the personnel files. Not maintaining documentation of required TB clearance on site and available for inspection poses/posed a potential health and safety risk of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Garfield Leung
NAME OF LICENSING PROGRAM MANAGER:
Brendon Van
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2026


LIC809 (FAS) - (06/04)
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