414004442-7-8-2026-05-CC-BVAN-DVSPUZ-20260708113822

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004442
Report Date: 07/08/2026
Date Signed: 07/08/2026 11:38:47 AM

Document Has Been Signed on 07/08/2026 11:38 AM - 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:	SILVA, JOSY		FACILITY NUMBER:	414004442
ADMINISTRATOR/ DIRECTOR:	SILVA, JOSY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 347-7498
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	07/08/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Josy Silva		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

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On July 8, 2026, Licensing Program Analyst (LPA) Van conducted an announced annual inspection and met with Licensee Josy Silva. The purpose of the inspection was explained, and the licensee granted LPA access to the home. Upon entering, LPA observed children having breakfast. The licensee and her assistant supervised eight children (three infants and five preschoolers), which is within the licensed capacity and limitations.

The licensee and all individuals residing in the home have verified criminal record clearances through the CDSS Background Check System and maintain eligible clearance status on file.

According to the licensee, there were no changes to the previously approved childcare areas. The child care areas are the living room (main day care area), the family room next to the garage (not currently in use and functioning as a pass-through area to the backyard), the hallway bathroom, and the backyard. The off-limit areas are the kitchen, all bedrooms, bathroom #2 located in the master bedroom, and the garage. All off-limit areas were properly barricaded.

The facility operates Monday through Friday, from 7:30 a.m. to 5:30 p.m.

LPA toured and inspected all childcare areas for potential health and safety hazards. Approved areas were observed to be safe, clean, and well organized. Age-appropriate toys were available throughout the childcare spaces, including educational, imaginative, and sensory materials, all in good condition and free of hazards.

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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026

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.

LIC809 (FAS) - (09/23)

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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: SILVA, JOSY	FACILITY NUMBER: 414004442
	VISIT DATE: 07/08/2026

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The home is equipped with a fully charged fire extinguisher, a pull-down fire alarm system, and operational smoke detectors. A carbon monoxide detector was also tested during the visit and found to be in working condition. A fully stocked first-aid kit was accessible.

Cleaning supplies and disinfectants were stored out of children’s reach. The licensee confirmed that no guns or weapons were present in the home. No baby walkers, bouncers, or other prohibited equipment were observed. The licensee was reminded that smoking is not permitted in the family child care home.

Two Pack N Plays were observed in the childcare area. LPA observed that one Pack ' n Play had a loose bedsheet. LPA reminded the licensee that all crib and Pack N Play sheets must be tight fitted to prevent dislodging, which could pose a risk of strangulation or suffocation. The licensee immediately replaced the sheet with a properly fitted one during the visit. A technical violation was issued.

LPA also observed a mobile hanging above another Pack ' n Play. LPA reminded the licensee that mobiles and hanging objects must not be placed above sleeping equipment, as they can pose entanglement or strangulation hazards. The licensee acknowledged the guidance and removed the mobile during the visit. A technical violation was issued.

The licensee provided the 15-minute infant sleep logs for review, which were complete and included the child’s name, the date, documented 15-minute checks, and staff initials. LPA reminded the licensee to maintain at least 30 days of logs for annual review, to retain records for three years, and that sleep sacks are not permitted in the facility.

Temporary absence requirements were reviewed. LPA reminded the licensee that they must remain on the premises to ensure children are supervised at all times. If the licensee must leave, the temporary absence may not exceed 20% of the facility’s daily operating hours.

All required licensing postings were observed, including the facility license and Notification of Parents’ Rights. However, the Earthquake Preparedness Checklist was not posted. During the visit, the licensee printed the checklist and immediately posted it in the home.

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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026

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: SILVA, JOSY	FACILITY NUMBER: 414004442
	VISIT DATE: 07/08/2026

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The licensee reported that regular fire and earthquake drills are conducted at least once every six months, with the most recent drill completed on 6/1/2026.

During the visit, LPA reviewed both children’s and personnel records. Child files were complete and included vaccination records, parental rights forms, and emergency information. Personnel records were also in order, with documentation of required immunizations, a valid Pediatric First Aid/CPR certification valid until 9/24/2026, and a current mandated reporter training certificate valid until 7/27/2026.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: www.ada.gov/childqanda.htm.

LPA discussed the safe sleep regulations with the Licensee and discussed the Child Care Licensing Safe Sleep web page https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. 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.

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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026

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: SILVA, JOSY	FACILITY NUMBER: 414004442
	VISIT DATE: 07/08/2026

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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.

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

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.

During the exit interview, the LICENSEE, JOSY SILVA, confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

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

An exit interview was conducted, and the report was reviewed with the licensee, Josy Silva.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026

LIC809 (FAS) - (06/04)

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