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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002244
Report Date: 05/16/2023
Date Signed: 05/16/2023 02:50:31 PM

Document Has Been Signed on 05/16/2023 02:50 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:LOPEZ, CARMEN L.FACILITY NUMBER:
414002244
ADMINISTRATOR:LOPEZ, CARMEN L.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 688-5729
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
05/16/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Carmen LopezTIME COMPLETED:
03:05 PM
NARRATIVE
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On May 16, 2023 at 02:20 PM, Licensing Program Analyst (LPA) Maria Olguin-Leon, conducted an unannounced, plan of correction (POC) visit. LPA met with Licensee, Carmen Lopez, and explained the purpose of the visit. Present during LPA visit included Licensee, 2 helper and 8 enrolled children (4 preschoolers and 4 infants).

On May 03, 2023, LPA Olguin-Leon met with licensee to conduct an unannounced, annual inspection visit. During annual visit, LPA observed facility to be operating over capacity with 9 enrolled children, 3 preschool age (over 24 months) and 6 infants (under 24 months). LPA issued a Type A citation for operating over licensed capacity limits. A POC was developed with licensee.

As of this date, LPA observed the licensee to be operating with 8 enrolled children, 4 preschool age (over 24 months) and 4 infants (under 24 months). 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 enrolled children. LPA collected schedule of children enrolled.

Deficiency cited on May 3, 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, Carmen Lopez.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2023
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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