414002060-5-9-2023-05-CC-CQUO-CRNTHL-20230509144456

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002060
Report Date: 05/09/2023
Date Signed: 05/09/2023 02:45:03 PM

Document Has Been Signed on 05/09/2023 02:45 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	MADLAMBAYAN, LUCIA CECILIA		FACILITY NUMBER:	414002060
ADMINISTRATOR:	MADLAMBAYAN, LUCIA C.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 873-5837
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 9	CENSUS: 7	DATE:	05/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Lucia Madlambayan		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On May 9, 2023 at approximately 1:05pm, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an unannounced, annual inspection. LPA met with licensee, Lucia Madlambayan, and explained the purpose of the inspection. Present during LPA's visit included licensee, licensee's assistant/adult son, licensee's spouse and 7 preschool age children. Licensee is operating within capacity limits and ratio during LPA's visit. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are Monday through Friday 7:30am to 6:00pm. Licensee lives in single level home with their spouse. The DAY CARE AREAS are the living room (main classroom), dining area, bathroom #1, kitchen, family room (napping room), and backyard. The OFF LIMIT AREAS are all bedrooms, garage and side yards. Off limit areas are made inaccessible with locked doors. Licensee is aware prior to use of an off limit area as a day care area, department must approve of space. LPA toured day care areas of home with licensee. Licensee operates home as a Montessori program. LPA observed home to be in good repair with proper temperature and ventilation. There were a variety of Montessori toys and materials that were in good working condition. LPA did not observe any poisons, cleaning solutions or hazards to be accessible to children. Main classroom includes a fire place that is properly barricaded by furniture. Kitchen was observed to have child safety locks on accessible cabinets and drawers. Licensee has licensing documentation properly posted and available for review near front entrance of home. Bathroom for children's use was observed to be clean and in proper working condition. Bathroom is equipped with appropriate toileting equipment and appropriate sanitation products. LPA did not observe any poisons, chemicals or hazardous materials in accessible cabinets or drawers in bathroom. Home is equipped with a first aid kit, fully charged fire extinguisher, and multiple smoke and carbon monoxide detectors throughout home. Licensee maintains a firearm that is stored and properly locked in an off limit room, away from children. (Continue Report on Page 2...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MADLAMBAYAN, LUCIA CECILIA	FACILITY NUMBER: 414002060
	VISIT DATE: 05/09/2023

NARRATIVE

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Entire outdoor area is enclosed with an at least 4 ft. high fence. Outdoor area is equipped with outdoor toys and materials that were in good working condition. LPA did not observe any pools, spas or bodies of water on the property.

LPA reviewed six children’s records. Children’s files have a record of emergency identification information on file. Licensee's Pediatric First Aid/CPR has just be renewed and will expire 04/2025. Assistant's First Aid/CPR is also current and will expire 04/2025.

Last emergency drill was conducted 12/12/2022. Emergency drills are conducted at least once every six months. Per licensee, next emergency disaster drill is scheduled for 05/16/2023.

LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com. Licensee was reminded Mandated Reporter training must be renewed every 2 years and all staff whom directly work with children must complete training.

Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: www.ada.gov/childqanda.htm.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MADLAMBAYAN, LUCIA CECILIA	FACILITY NUMBER: 414002060
	VISIT DATE: 05/09/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/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 at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

No deficiencies were cited today under CCR, Title 22, Div. 12.

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

Exit interview conducted and report was reviewed with the licensee, Lucia Madlambayan.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

LIC809 (FAS) - (06/04)

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