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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004284
Report Date: 03/19/2026
Date Signed: 03/19/2026 01:53:41 PM

Document Has Been Signed on 03/19/2026 01:53 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:OLSEN-DONIO,ROSSANNA M.FACILITY NUMBER:
414004284
ADMINISTRATOR/
DIRECTOR:		OLSEN-DONIO, ROSSANNA M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 994-2540
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
03/19/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:56 AM
MET WITH:Licensee, Rossanna M. Olsen-DonioTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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On March 19, 2026, at approximately 9:00AM Licensing Program Analyst (LPA) Alvarado conducted an unannounced annual visit at the facility. Facility entrance is on the left side of the home (driveway side). LPA Alvarado met with the Licensee, Rossanna M. Olsen-Donio (L1). LPA Alvarado observed Present in the Facility is (L1) and assistant supervising (5 Preschoolers). Facility is a large license and is operating within capacity limits and ratio during today’s inspection. (L1) was reminded that if no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in 102416.5 Staffing Ratio and Capacity. Everyone present in the household has fingerprint clearance and are associated to the facility as of today’s inspection. During the inspection 5 more preschoolers arrived with a total of (L1) and assistant supervising a total of 10 children. (L1) stated that the home has two cats that are located in an off limit portion of the home and do not come in contact with children.

Day Care Area: family room and bathroom located in the family room (Main Day Care Area), covered patio area, and backyard.

Off Limits Area: Off limit areas are the entire upper level, and on the lower level, kitchen, garage, and living room.

LPA along with (L1) inspected the home for any health or safety hazards indoors and outdoors. The home is clean and in orderly condition. The home is equipped with a fire extinguisher and reminded (L1) that the fire extinguisher would need to be at least a 2-A:10-B:C fire extinguisher. Facility has a duo smoke and Carbon monoxide detector, that were tested and observed to be functioning during today’s inspection.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

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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: OLSEN-DONIO,ROSSANNA M.
FACILITY NUMBER: 414004284
VISIT DATE: 03/19/2026
NARRATIVE
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No fireplaces were observed in the Day Care Area. Facility has cubbies that are designated for children’s belongings in the entrance of the facility. Facility has all off limit areas properly barricaded and made inaccessible to children. Outdoor space was observed to have a large open grass area, with a small step that leads to a space that has outdoor equipment such as a wooden home with a slide, and swing set. Tables were also observed where (L1) stated that the children enjoy lunch outdoors if weather permitted. LPA observed sufficient padding for landing zones. A large shed was observed, that has a lock and is off limits for child use. (L1) also has a space along the fence that is utilized for gardening. Outdoor space has a fence that encloses the yard that is at least 4ft high.

Facility hours of operation are Monday-Thursday 8:15AM-5:00PM. LPA observed age-appropriate toys and learning materials to be present. Furniture is age-appropriate and free of rough, loose, or sharp edges. Wall outlets were observed to be child proof. Per (L1) Facility provides Morning Snack, Lunch and Afternoon. (L1) stated that facility provides napping equipment such as individual cushioned mats and are washed as needed. LPA observed the children’s bathroom, which includes two sinks and two toilets, to be functional during today’s inspection, children’s bathroom located in the family room which is the main day care area and is only for child use. Per (L1) there are no firearms present in the facility. All chemicals and Poisons are locked and made inaccessible to children. No pools, hot tubs, spas, fishponds or similar bodies of water observed on the property. (L1) also confirmed there were no bodies of water on property. (L1) was reminded that Babywalkers, bouncers, jumpers and similar items will not be used for children in care and are not allowed even through the facility primarily works with preschool age children.

LPA reviewed two personnel records where (L1) and assistant do not have current Mandated Reporter Training and Current Pediatric First Aid/CPR. (L1) during the inspection called to make an appointment for the Pediatric First Aid/CPR. LPA reminded (L1) that Pediatric First Aid/CPR and Mandated Reporter Training need to be renewed every two years and for all assistants who are providing care to children.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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: OLSEN-DONIO,ROSSANNA M.
FACILITY NUMBER: 414004284
VISIT DATE: 03/19/2026
NARRATIVE
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LPA reviewed seven child’s records out of the ten that were present, that were observed to have completed required documents. (L1) does not have any infants 24Months and under and was reminded that in the future if facility takes in Infants to ensure that the Infant Safe Sleep is followed.

LPA reviewed Facility Records and observed required documents posted and available for review. Reminding (L1) of a few that were missing and provided during today’s inspection. Facility has not documented the Emergency Disaster Drills and LPA reminded (L1) that emergency drills must be continued to be conducted and documented once every six months. Facility has Current General Liability that is current from 6/2025-6/2026 (L1) also provided LPA with the proof of the upcoming Liability insurance that will be effective as of 6/2026-6/2027. Entrance Checklist for Family Child Care Homes (LIC 126) was provided to (L1) for reference.

(L1) 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.

During the inspection, (L1) informed LPA that there was a person who was present being supervised that was a possible hire at the facility, who had arrived and licensee stated that the Possible hire was being supervised and wanted to make sure she was a match with the facility. This individual was not left alone and was being supervised by the other assistant and (L1) who is fingerprinted and clear.

LPA discussed the safe sleep regulations with (L1) and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for and removing any 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.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
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: OLSEN-DONIO,ROSSANNA M.
FACILITY NUMBER: 414004284
VISIT DATE: 03/19/2026
NARRATIVE
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(L1) stated that they primarily work with preschool age children.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

(L1) 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, Rossanna M. Olsen-Donio confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

See LIC 809-D for deficiencies being cited today on March 19, 2026 under the California Code of Regulations, Title 22, Division 12, Chapter 1. Regarding Facility Administration and Records.

See LIC9102-TV for Technical Violation issued today regarding Physical Plant and Facility Administration.

See LIC9102-TA for Technical Advisory issued today regarding Physical Plant, Facility Administration, and Records.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were provided to (L1).Exit interview conducted and report was reviewed with the licensee, Rossanna M. Olsen-Donio .
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC809 (FAS) - (06/04)
Page: 5 of 13
Document Has Been Signed on 03/19/2026 01:53 PM - It Cannot Be Edited


Created By: Diana Alvarado On 03/19/2026 at 12:16 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: OLSEN-DONIO,ROSSANNA M.
FACILITY NUMBER: 414004284

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/19/2026

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
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in two out of two persons, Licensee and assistant did not have current Mandated Reporter Training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/03/2026
Plan of Correction
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LPA reminded the licensee that Mandated Reporter Training must be completed by the licensee and assistants when present with children. Licensee will submit proof of the completed Mandated Reporter Training (4HRS) To LPA Alvarado by 4/3/2026 and Licensee will also ensure to maintain in each file such as for the licensee and assistant file. LPA will also conduct a follow up inspection to ensure that the certificate is being maintained.
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in two out of two persons, Licensee and assistant did not have current Pediatric First Aid/CPR which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/03/2026
Plan of Correction
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LPA reminded the licensee that the Pediatric First Aid/CPR Training that is issues by the American Red Cross or the American Heart Association or by an approved Emergency Medical Services Authority (EMSA) vendor must be completed by the licensee and all assistants when present with children. Licensee during the inspection contacted a company to make an appointment. Licensee will submit proof of the enrollment for the Pediatric First Aid/CPR. Licensee and assistant will ensure to complete the training and submit proof of the certificate once fully completed by 4/3/2026. LPA will also conduct a follow up inspection to ensure that the certification is being maintained.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:
Diana Alvarado
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/19/2026


LIC809 (FAS) - (06/04)
Page: 6 of 13
Document Has Been Signed on 03/19/2026 01:53 PM - It Cannot Be Edited


Created By: Diana Alvarado On 03/19/2026 at 12:16 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: OLSEN-DONIO,ROSSANNA M.
FACILITY NUMBER: 414004284

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/19/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in one out of one document, Facility has not maintained the Facility Roster which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/03/2026
Plan of Correction
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Licensee will ensure to fill out and complete the Facility roster. LPA reminded the licensee that the Facility Roster must be maintained for 3 years and be kept up to date. Licensee will submit proof of the Facility Roster (LIC 9040) by 4/3/2026 and LPA will conduct a follow up inspection to ensure that documents are being maintained.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:
Diana Alvarado
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/19/2026


LIC809 (FAS) - (06/04)
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