414004558-4-10-2023-05-CC-MOLN-CQRW55-20230410165835

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004558
Report Date: 04/10/2023
Date Signed: 04/10/2023 04:58:46 PM

Document Has Been Signed on 04/10/2023 04:58 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PISSANI, MIGUEL A.		FACILITY NUMBER:	414004558
ADMINISTRATOR:	PISSANI, MIGUEL A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 533-7213
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 8	DATE:	04/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:47 PM
MET WITH:	Miguel Pissani		TIME COMPLETED:	05:10 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 April 10, 2023 at 1:45 PM Licensing Program Analyst (LPA) Maria Olguin-Leon met with Miguel Pissani for required annual inspection. Purpose of inspection was explained. Present today wasLicensee, 2 staff, 8 children (4 infants, 2 preschoolers, 2 school age). Facility is operating within the capacity and in compliance with staff child ratio. Facility operates from program from Monday to Friday 8:00AM to 5:00PM. LPA and Licensee toured the home to conduct a Health and Safety Inspection. The home is a single level home with two bedrooms and one bath. On limit areas are living room, dining room, bathroom, and backyard. Off limits area is the kitchen, garage and both bedrooms. Licensee is currently using bedroom #2 for napping purpose and will submit a new facility sketch to our department. The home is in good repair and free of hazards and has proper heating and ventilation. There are plenty of age-appropriate toys, playpens and learning materials all in good repair. There are no pools or bodies of water. Per licensee there are no weapons in the home. The home is equipped with a fully charged fire extinguisher, a working carbon monoxide detector and smoke detector. All cleaning supplies and toxins are properly stored behind locked cabinets. LPA reminded Licensee to keep latches on at all time and replace any broken latches. Last emergency drill was conducted on 2/2023. CPR/First Aid is current until 2//202. Mandated reporter 6/2023. First aid kit is available and equipped with necessary supplies. Isolation area will be in back room. LPA reviewed 6 children’s records. All the children's records were complete and infant sleep logs were observed. The home has all necessary paperwork posted. Two staff files were reviewed, staff is missing mandated reporter training, technical assistance was cited. Licensee was given a copy of LIC126. Licensee provides breakfast, lunch, and snacks. As per licensee, there is no firearm or weapon in the home. Facility provides breakfast, two snacks and lunch. Incidental Medical Services were discussed. Licensee was reminded to always keep cell available at facility. Cont. page 2...

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PISSANI, MIGUEL A.	FACILITY NUMBER: 414004558
	VISIT DATE: 04/10/2023

NARRATIVE

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Safe Sleep
LPA discussed the safe sleep regulations with licensee Miguel Pissani 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 resources.

Incidental Medical Services (IMS) policy was discussed. Licensee does not offer IMS at this time. 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.

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.

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 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.coLm.

LPA encouraged Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PISSANI, MIGUEL A.	FACILITY NUMBER: 414004558
	VISIT DATE: 04/10/2023

NARRATIVE

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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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee, Miguel Pissani.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/10/2023 04:58 PM - It Cannot Be Edited

Created By: Maria Olguin-Leon On 04/10/2023 at 04:35 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: PISSANI, MIGUEL A.	FACILITY NUMBER: 414004558
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/10/2023

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 and inspection the licensee did not comply with the section cited above in two counts out of two, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2023
	Plan of Correction
1 2 3 4	The Licensee must ensure that the Mandated Reporter Training is completed every two years and available for review during the inspection. The Licensee states she will complete the training on or before March 30, 2023.

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:

Ali Zebila

LICENSING EVALUATOR NAME:

Maria Olguin-Leon

LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

LIC809 (FAS) - (06/04)

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