414004768-5-31-2024-05-CC-CQUO-D5SSJ5-20240531135434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004768
Report Date: 05/31/2024
Date Signed: 05/31/2024 01:54:39 PM

Document Has Been Signed on 05/31/2024 01:54 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:	SANDINO, ADELA		FACILITY NUMBER:	414004768
ADMINISTRATOR/ DIRECTOR:	SANDINO, ADELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 731-4737
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 5	CENSUS: 5	DATE:	05/31/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:15 AM
MET WITH:	Adela Sandino		TIME VISIT/ INSPECTION COMPLETED:	02:00 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 May 31, 2024 at approximately 11:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Adela Sandino, and explained the purpose of the visit. Present during LPA's visit included 5 children (2 infants and 3 preschool age). Licensee is operating within capacity limits and ratio during LPA's visit. Licensee lives in the multi-level home with their adult child, cousin, and adult niece. All adults living in the home have fingerprint clearance on file. Hours of operation are Monday through Friday 8:00am to 6:00pm. LPA inspected day care areas of home for health and safety hazards. The DAY CARE AREAS are the living room, kitchen, ground floor bathroom, backyard and family room (located on second floor, not currently in use). The OFF LIMIT AREAS are bedroom #1 (located on ground level of the home), garage, and all bedrooms and bathrooms located on second level of the home. Off limit areas are made inaccessible with locked doors. There are stairs to the second level of the home that are made inaccessible with a child safety gate. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and materials that were observed to be in good condition. There is a fireplace in the living room that is made inaccessible to children. LPA did not observe accessible poisons in day care areas. Carpet in home was observed to be clean and free of stains. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers. Cabinets in kitchen were observed to have child safety locks installed. Home is equipped with multiple fully charged fire extinguishers, multiple first aid kits and multiple dual smoke/carbon monoxide detectors. Bathroom for children's use was observed to be in working condition. Bathroom is equipped with appropriate toileting equipment. LPA observed cabinet in bathroom to also include a child safety lock. LPA observed shampoo and body washes to be in shower's high shelves, inaccessible to children. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SANDINO, ADELA	FACILITY NUMBER: 414004768
	VISIT DATE: 05/31/2024

NARRATIVE

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Entire backyard is fully fenced and enclosed. Backyard includes outdoor toys and materials that were in good condition. Flooring in backyard includes artificial turf that is in good condition. LPA did not observe any pools, spas or bodies of water on site.

All children currently enrolled sleep on cots. LPA observed cots and children's sheets to be appropriately stored. Children's sheets were observed to not be touching one another. LPA did not observe any cribs on site. Licensee stated they are aware if an infant sleeps in a crib, crib must be free of loose articles and materials.

LPA reviewed 5 children's records, which were complete. Children's files have a record of emergency information on file. LPA reviewed licensee's file which includes licensee's required immunizations. Licensee's CPR/First Aid certification is current and will expire 07/2025. Licensee's Mandated Reporter certification is also current and will expire 08/2025. LPA reminded licensee Mandated Reporter certification must be renewed every two years and completed by all staff working with children.

Home has licensing documentation properly posted and available for review. There is a firearm in the home that is maintained separate from the day care area. LPA observed firearm to be stored in a locked box, in an off limit bedroom.

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.
(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

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: SANDINO, ADELA	FACILITY NUMBER: 414004768
	VISIT DATE: 05/31/2024

NARRATIVE

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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-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.

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-carecenters/

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, the licensee, Adela Sandino, 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 during LPA's visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Adela Sandino.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

LIC809 (FAS) - (06/04)

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