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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002734
Report Date: 03/03/2023
Date Signed: 03/03/2023 03:32:58 PM


Document Has Been Signed on 03/03/2023 03:32 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:MELENDEZ, GLENDA B.FACILITY NUMBER:
414002734
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
03/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:53 PM
MET WITH:Glenda MelendezTIME COMPLETED:
03:45 PM
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On March 3, 2023 at 1:55 PM.,Licensing Program Analyst (LPA) Maria Olguin-Leon met with licensee, Glenda Melendez, for an annual random inspection. The purpose of the inspection was explained. Licensee was the only one present for today's visit. Licensee operates Mon-Fri. 8:00-5:30 PM.

Licensee and LPA toured home for health and safety hazards. Day Care Areas: Living room, Kitchen/dining area. Off limit areas: Bedroom #1. Master bedroom is used for napping purposes only. Outdoor area has plenty of age appropriate toys and off limits area is barricaded with a wooden fence.

Per licensee, there is no firearm or weapon in the house. All the cleaning supplies, poisons and other chemicals are stored inaccessible to the children. Kitchen cabinets have child protective locks in place. The house is in good repair and free of hazards with proper temperature and ventilation. Home has age appropriate toys and activities for children in care.

Home has two carbon monoxide/smoke detector in all the bedrooms and a fully charged fire extinguisher. Licensee uses cell phone and understand phone is to be kept on premises at all time. Mandated Reporter certificate has expired, Licensee will submit certificate when completed. CPR/First Aid is current and expires 10/2024. Per licensee emergency drills are conducted. LPA reviewed three children records and all documents were available. Licensee has all of the required documents posted and are visible for the public.

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.

Cont. page 2
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
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: MELENDEZ, GLENDA B.
FACILITY NUMBER: 414002734
VISIT DATE: 03/03/2023
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LPA also informed the 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.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee
was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility
unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption
pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As
of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be
obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations
and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be
added to the email list for the updates.

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.

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.

No deficiencies on this day. Exit interview conducted and report was reviewed with the licensee, Glenda Melendez.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC809 (FAS) - (06/04)
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