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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001759
Report Date: 12/15/2023
Date Signed: 12/15/2023 04:11:52 PM


Document Has Been Signed on 12/15/2023 04:11 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:CHAVEZ, MONICA & AVILES, MONICAFACILITY NUMBER:
414001759
ADMINISTRATOR:CHAVEZ, MONICA & AVILES, MFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 568-9845
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY:14CENSUS: 12DATE:
12/15/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Monica AvilesTIME COMPLETED:
04:30 PM
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On December 15, 2023 at approximately 2:35 PM, Licensing Program Analyst (LPA) Maria Olguin-Leon, conducted an unannounced, plan of correction (POC) visit. LPA met with Licensee, Monica Aviles and explained the purpose of the visit. Present during visit was Licensee, two helpers and 12 children (3 infants and 9 preschool age). Licensee is within ratio of staff/children capacity.

On December 12, 2023, LPA Maria Olguin-Leon met with licensee for an annual inspection. During visit, LPA observed facility to be operating over capacity with 3 infants and 11 preschoolers. LPA issued a Type A citation for operating over licensed capacity limits. A POC was developed with licensee.

As of this date, LPA Olguin-Leon confirmed the licensee to have three infants and nine preschoolers present. LPA collected children’s roster indicating children’s schedule. During today’s visit LPA and Licensee reviewed schedule together. Per licensee roster reflects children’s schedule of days each child will be attending daycare. Per licensee one child will stay home with parents for remainder of year and begin preschool in January. Another child will only attend Mondays, which will keep licensee within capacity ratios each day. LPA observed licensee to be operating within licensed capacity limits on this date.

During today's visit, LPA observed signed and completed Acknowledgement of Receipt of Licensing Reports (LIC9224) for the 16 children currently enrolled. LPA reminded Licensee that all newly enrolled children in the next 12 months must have a LIC 9224 on file. LPA observed facility site visit and reports posted.

Deficiency cited on December 12, 2023, has been cleared as of this date. LPA provided licensee copy of POC letter. No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with licensee, Monica Aviles.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2023
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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