414004256-7-30-2024-05-CC-MZAA-D7P2DZ-20240730171909

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004256
Report Date: 07/30/2024
Date Signed: 07/30/2024 05:19:16 PM

Document Has Been Signed on 07/30/2024 05:19 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:	MELAZZO, NEIDEMAR A.		FACILITY NUMBER:	414004256
ADMINISTRATOR/ DIRECTOR:	MELAZZO, NEIDEMAR A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 685-8270
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 11	DATE:	07/30/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:30 PM
MET WITH:	Licensee, Neidermar Melazzo		TIME VISIT/ INSPECTION COMPLETED:	05:30 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 July 30, 2024 at approximately 2:30pm, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA was greeted and granted access by the licensee, Neidemar A. Melazzo. At the entrance licensee was explained the purpose of the inspection. Present during LPA's visit included Licensee, 2 staff, and 11 children (4 infants and 7 preschool age). Hours of operation are Monday through Friday 7:00am to 5:30pm. Licensee lives in a one-level home. All adults living in the home and staff present, have fingerprint clearance on file. The DAY CARE AREAS are Bedroom #1 (napping room), Bedroom #2, living room, bathroom #1, and backyard, bedroom #3 is for walk through only. The OFF LIMIT AREAS are the kitchen, garage, laundry room, and bedroom #3. Off limit areas are made inaccessible with child safety gates. LPA toured day care areas of home with licensee. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good condition. Cleaning supplies, poisons and hazardous materials are stored in home's high shelves and/or locked behind child safety locked cabinets. Home is equipped with a fully charged fire extinguisher and a smoke and carbon monoxide detector. Smoke and carbon monoxide detectors were tested during visit and was observed to be in working condition. There are no pools, and bodies of water in the premises. Napping room (bedroom#1) was observed to be equipped with cribs, playpens, and cots for napping children. Cribs, and playpens were observed to be free of loose articles, bumper pads and pillows. LPA observed cribs and playpens to have mattresses with tight fitting sheets. Sleeping logs for napping infants are maintained and includes the 15 minute time check of when infant was last checked on. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: MELAZZO, NEIDEMAR A.	FACILITY NUMBER: 414004256
	VISIT DATE: 07/30/2024

NARRATIVE

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Bathroom was observed to be in proper working condition. There is appropriate sanitation and toileting equipment for children in care. LPA observed children’s diapers and wipes in cubbies to be properly stored for each individual child. Per licensee, children’s families provide diapers and wipes for enrolled children.

Children eat in living room. A food service is provided to children that includes breakfast, lunch and snack. LPA observed eating area to be clean and equipped with appropriate dining furniture. LPA observed knives to be made inaccessible.

Outdoor area is entirely enclosed and fenced. Outdoor area includes a variety of toys and equipment that were in good condition. Outdoor area has fake grass flooring and has a canopy for shade. LPA did not observe any pools, spas or bodies of water on site.

LPA reviewed 6 random children's records which were complete. LPA reviewed licensee’s and all staff who were present records, which were complete

Emergency disaster drills are conducted and are appropriately documented. Last disaster drill was conducted 02/03/2024. LPA observed licensing documentation to be properly posted, made available for review. Facility maintains a childcare roster that was also made available for review. Per licensee, there is no firearms or weapons in the home.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MELAZZO, NEIDEMAR A.	FACILITY NUMBER: 414004256
	VISIT DATE: 07/30/2024

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee, Neidemar A. Melazzo, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed a Megan’s Law search on 7/30/24 .

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

Exit interview conducted and report was reviewed with the licensee, Neidemar A. Melazzo.

LPA was having printer issues and will email the report to the licensee.

LPA translated the report in Spanish to the licensee.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/30/2024 05:19 PM - It Cannot Be Edited

Created By: Melissa Zaragoza On 07/30/2024 at 04:31 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: MELAZZO, NEIDEMAR A.	FACILITY NUMBER: 414004256
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above, no staff present have their Madated Reporter Certification which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/13/2024
	Plan of Correction
1 2 3 4

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Melissa Zaragoza

LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

LIC809 (FAS) - (06/04)

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