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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004558
Report Date: 06/07/2023
Date Signed: 06/07/2023 09:25:44 AM

Document Has Been Signed on 06/07/2023 09:25 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 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 CITYSTATE: CAZIP CODE:
94061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
06/07/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:17 AM
MET WITH:Miguel PissaniTIME COMPLETED:
09:45 AM
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On June 7, 2023, at 08:10 PM, Licensing Program Analyst (LPA) Maria Olguin-Leon, conducted an unannounced, plan of correction (POC) visit. LPA met with Licensee, Miguel Pissani, and explained the purpose of the visit. Present during LPA visit included Licensee, 2 helper and 9 enrolled children (5 preschoolers and 4 infants).

On May 24, 2023, LPA Olguin-Leon met with licensee to conduct unannounced case management deficiencies visit. During case management visit, LPA cited for operating over capacity on 04/26/2023 with 9 children present, 4 preschool and 5 infants. LPA issued a Type A citation for operating over licensed capacity limits. A POC was developed with licensee.

On May 24, 2023, LPA cited for Infant Safe Sleep and issued Type B citation. A POC was developed with Licensee. As of 04/27/2023, Licensee email a photo to LPA to clear citation. Licensee installed curtains in napping room and removed playpen coverings.

As of this date, LPA observed the licensee to be operating with 9 enrolled children, 5 preschool age (over 24 months) and 4 infants (under 24 months). LPA observed licensee to be operating within licensed capacity limits on this date.

During today's visit, LPA observed signed and completed Acknowledgement of Receipt of Licensing Reports (LIC9224) for enrolled children. LPA collected schedule of children enrolled.

Deficiencies cited on May 24, 2023, has been cleared as of this date. LPA provided licensee copy of POC letter. No deficiencies were cited today.

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: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2023
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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