<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004687
Report Date: 03/22/2024
Date Signed: 03/22/2024 02:02:03 PM

Document Has Been Signed on 03/22/2024 02:02 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:OLIVARES, CLARISAFACILITY NUMBER:
414004687
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 5DATE:
03/22/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Licensee, Clarisa OlivaresTIME COMPLETED:
02:20 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 March 22nd, 2024 at approximately 11:55am, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced inspection for an increase of capacity today and met with licensee, Clarisa Olivares for her request to increase from a Small license to a Large Family Child Care license. Licensee has also requested to add an additional space in the backyard. Fire Clearance was received by Redwood City Fire Department on 03/13/24.
Present in the home are licensee and assistant supervising 5 children (3 infants 2 preschool age). Licensee is within capacity limits on this day. All adults living and working in the home have fingerprint clearance and are associated to the facility.

Licensee rents home, which is a two bedroom, one bathroom, single level house. Licensee lives in the home with two adult daughters. The Hours of Operation are Monday-Friday from 7:45am-5pm. LPA inspected the entire home for health and safety risks. LPA also inspected the new area that will be added in the backyard. LPA observed that the backyard is safe and free of hazards. Entire backyard is fenced and all potential hazards are either behind locks doors or barricaded by a baby gate. LPA has approved the new area for use as of today's inspection.

New Daycare areas are: Living Room, Bedroom #1 (sleeping/changing diapers only), Bathroom #1, Kitchen/Dining area, and back yard (adjacent to the kitchen), side yard (adjacent to the rooms). OFF limit areas: Bedroom #2, and Front Yard. All off limit areas, including all closets, are properly barricaded.

Continued on Page 2...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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 2
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: OLIVARES, CLARISA
FACILITY NUMBER: 414004687
VISIT DATE: 03/22/2024
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
26
27
28
29
30
31
32
Page 2 Continued...

LPA observed home to be clean and in good repair with proper temperature and ventilation. There is a variety of age-appropriate toys and equipment in the home which are in good condition. There are no pools, spas, or bodies of water on the property. Home does not have a fireplace. Per licensee, she has a pet dog with proper documentation.

Each Infant child has a pack and play to sleep in. Infant children sleep in Bedroom #1. Licensee was reminded of the Safe Sleep Regulations on this date. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children.

LPA observed fire alarm installation on the living room wall by Important Postings with evacuation plan. There is a fully charged fire extinguisher, and a working telephone. Backyard is fenced and properly barricaded. Evacuation exits are the main entrance and the Side gate that leads to the side of the house. Per Licensee, there are no weapons or firearms in the home. Licensee's CPR & First Aid expires on 04/2024. Licensee's Mandated Reporter certificate expires on 05/2025. Licensee is reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible.

Capacity limits of a Small and Large Family Child Care Home were explained. Per Redwood City Fire Department, Capacity of 11 children were approved with two adults present for a total of 13 people. LPA provided a Capacity Worksheet with the appropriate capacity for this facility.

LPA will reccommend for approval of a Large Family Child Care Home License as of today, March 22nd, 2024.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

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

Exit interview was conducted and report was reviewed and translated into Spanish to licensee, Clarisa Olivares.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2