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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004559
Report Date: 11/16/2023
Date Signed: 11/16/2023 11:52:18 AM

Document Has Been Signed on 11/16/2023 11:52 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:CUEVAS-CENDEJAS, ZENAYDA & GILES, RAULFACILITY NUMBER:
414004559
ADMINISTRATOR:CUEVAS-CENDEJAS, ZENAYDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 218-7602
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
11/16/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Licensees, Zenayda Cuevas-Cendejas and Raul GilesTIME COMPLETED:
12:10 PM
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On 11/16/2023, at approximately 8:55AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced visit to the facility listed above. LPA was granted entry to the facility by licensee, Raul Giles. LPA explained the purpose of the visit. Present during the visit were Licensees Raul Giles and Zenayda Cuevas-Cendejas, three infants and one preschool age child. The facility is in compliance with capacity requirements. The facility's operating hours are from 8AM to 5:30PM, Monday to Friday.

LPA and Licensee Raul Giles inspected the facility for any health and safety hazards. The home is a single-level home with three bedrooms, one bathroom, a living room, dining area, kitchen, garage, and backyard.

Daycare Areas: Living Room, Dining Area, Bathroom, Bedroom 1, and Backyard.
Off-limits Areas: Bedroom 2, Bedroom 3, Kitchen, and Garage.

LPA observed the home to be kept in clean and orderly condition. Bedroom 1 is designated for infant napping use. All electrical outlets are covered or obstructed by furniture so as to not be accessible to children. There are age-appropriate toys and learning materials present. There is a combination smoke and carbon monoxide detector that is operational. The facility is equipped with a fully charged 2A10BC fire extinguisher. There are child-proof locks located on the bathroom sink cabinet. The first aid kit is fully stocked with materials necessary to administer first aid. Per Licensee, there are no firearms located within the facility. There are no bodies of water located within the facility. There are heaters and a fireplace located within the facility, but they are barricaded so that they are inaccessible to children. Off-limits areas are kept inaccessible by child-proof gates or child-proof doorknobs.

The backyard was observed to be equipped with age-appropriate play structures and play equipment. There is turf installed in the backyard, which is sufficient cushioning for children. The backyard is secured by fences that are at least five feet high.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
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 4
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: CUEVAS-CENDEJAS, ZENAYDA & GILES, RAUL
FACILITY NUMBER: 414004559
VISIT DATE: 11/16/2023
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LPA reviewed Licensees' records and four children's records. Licensees' records were observed to be complete. All adults living in the home have acquire fingerprint clearance and are associated to the facility. Children's records were observed to be complete including LIC9150 (Parent Notification Additional Children in Care) for all children. Both licensees have current First Aid/CPR Training (expires 5/2025) and Mandated Reporter Training (expires 8/2025).

The facility maintains an emergency drill log, with the most recent Earthquake and Fire Drills being conducted on 8/18/2023. All required postings were observed to be posted and viewable at the entryway of the facility.

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 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.

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-andresources/safe-sleep as an additional resource. LPA also informed 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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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CUEVAS-CENDEJAS, ZENAYDA & GILES, RAUL
FACILITY NUMBER: 414004559
VISIT DATE: 11/16/2023
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee 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, Licensee Raul Giles, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited today.
See LIC9102-TV for Technical Violation regarding safe sleep.

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

Exit interview conducted and report was reviewed with the licensee, Raul Giles.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC809 (FAS) - (06/04)
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