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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004153
Report Date: 10/23/2024
Date Signed: 10/23/2024 03:08:52 PM

Document Has Been Signed on 10/23/2024 03:08 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:ROSALES, ROSALVAFACILITY NUMBER:
414004153
ADMINISTRATOR/
DIRECTOR:		ROSALES, ROSALVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 787-5736
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
10/23/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:01 PM
MET WITH:Rosalva RosalesTIME VISIT/
INSPECTION COMPLETED:
03:25 PM
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On October 23, 2024 @ approx. 2:00pm Licensing Program Analyst (LPA) Maria Olguin-Leon, conducted an unannounced, plan of correction (POC) visit. LPA were granted entrance by licensee, Rosalva Rosales and LPA explained the purpose of the visit. Present during today's inspection were Licensee and assistant supervising 5 children (4 infants and 1 preschooler). All adults living and working in the home have fingerprint clearance and are associated to the facility. Facility is operating within capacity limits on this day.

On October 10, 2024, LPA conducted an annual inspection. During the inspection, LPA determined facility had been operating over capacity with 4 infants and 1 preschooler. LPA observed helper was left alone with children. LPA issued a Type A citation for operating over licensed capacity limits. A POC was developed with licensee. LPA explained capacity limits and ratios for a large family day care with licensee. LPA reminded licensees that an assistant must be present when operating as a large license. LPA reminded licensees when an assistant is not present, licensees must operate within capacity limits of a small family child care home.

During today's inspection, LPA observed Notice of Site Visit posted with Type A reports, as well as observed that parents signed LIC 9224 'Acknowledgment of Receipt of Licensing Reports'.

As of this date, LPA observed the deficiency of over capacity was cleared. LPA observed cribs to be cleared of items in crib/playpens and observed blanket covers for cribs/playpens have been removed. LPA observed sleeping logs to be current for infants in care, deficiency was cleared. LPA also cleared the deficiencies for staff files, staff mandated reporter training, and removal of banned exersaucer and inclined sleeper from daycare area.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with licensee, Rosalva Rosales. LPA translated report in Spanish.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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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