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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004461
Report Date: 02/29/2024
Date Signed: 02/29/2024 11:34:42 AM

Document Has Been Signed on 02/29/2024 11:34 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:VALDERRAMA, MICKA A.FACILITY NUMBER:
414004461
ADMINISTRATOR:VALDERRAMA, MICKA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 963-6786
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
02/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Micka ValderramaTIME COMPLETED:
11:50 AM
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On February 29, 2024 @ approx. 9:20AM, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Micka Valderrama for an unannounced annual inspection. The purpose of the inspection was explained. Present for today’s visit was licensee, helper, spouse (working from home) and 9 children (3 infants & 6 preschoolers). All adults working at facility have fingerprint clearance. Licensee is operating within capacity and ratio requirements on this day. Hours of operation are Monday– Friday, 7:30-6:00pm.

LPA and Licensee toured the home for health and safety hazards. Home is a one-story home. Day Care Areas: Entrance foyer, toddler room, napping room (bedroom #2), hallway bathroom and backyard. Living room is used for morning/afternoon pickup/drop off and is walk through into toddler room and backyard. Off limit areas Kitchen, Bedrooms #1, #3 and #4, Garage, and living room. Child proof gates are located in both kitchen entrances and in hallway. Bathroom cabinets are equipped with childproof locks. Electrical outlets are properly secured with childproof covers. Home is well light and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to children. There are plenty of age-appropriate toys, books, child size furnishings, learning material, and cribs. Children's cubbies are located at living room entrance. There is a changing table located in bathroom. Backyard has age-appropriate toys, playhouse, and small slide. Outdoor backyard patio has brick flooring. The entire backyard is surrounded with a 5 ft. fence and a childproof gate is installed on side of home. Parents enter through side of home to drop off children in living room entrance. LPA did not observe any pools, spas, or other bodies of water.

Home is equipped with a dual working carbon monoxide/smoke detector and a fully charged fire extinguisher. Isolation area for ill children will be in napping room and away from other children. LPA reviewed first aid kit and kit is fully stocked. Licensee use cell phone on the premises. Per licensee, there are no weapons or firearms in the home. Licensee and parents provide sheets for playpens and are washed weekly.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: VALDERRAMA, MICKA A.
FACILITY NUMBER: 414004461
VISIT DATE: 02/29/2024
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LPA reviewed 5 children’s records and 2 staff records. All records are up to date. Licensee maintains an updated Children’s roster and safe sleep logs. Licensees CPR/FA expires 11/2025. Licensee Mandated Reporter training expires 11/2025. Licensee provides breakfast, lunch, and two snacks to children in care. LPA reminded Licensee to label children's food/bottles brought from home. LPA observed Childcare License, Emergency Disaster Plan (LIC610A) and Parent's rights posted. Last emergency drill was conducted on 08/2023 and properly documented. Licensee carries liability insurance via Accord insurance effective 02/2024-02/2025.

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.

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/.

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's reviewed AB 1207 with the Licensee.

As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com


Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: VALDERRAMA, MICKA A.
FACILITY NUMBER: 414004461
VISIT DATE: 02/29/2024
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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. LPAs also informed licensees 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. LPA discussed sleep sacks.

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 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.

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

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.

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

Exit interview conducted and report was reviewed with the licensee, Micka Valderrama.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
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