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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004782
Report Date: 07/05/2023
Date Signed: 07/05/2023 05:12:31 PM

Document Has Been Signed on 07/05/2023 05:12 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:TURCIOS, HEYDIFACILITY NUMBER:
414004782
ADMINISTRATOR:TURCIOS, HEYDIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 452-5510
CITY:SO. SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
07/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Heydi Turcios, Marisol TurciosTIME COMPLETED:
05:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Andrea Medlin met with facility representative for this required annual licensing visit today. Purpose of visit explained. Days and hours of operation: Monday-Friday 7:30AM-5:00PM. There are 6 children in care today; 2 infants, 3 preschool, and 1 school aged. Licensee states she, mother, father, sister, her minor child, and two adult tenants reside in the home; criminal record clearance is on file for all adults in the home. Physical plant toured to inspect for health and safety hazards in the licensed areas. Outdoor space inspected for health and safety hazards; outdoor areas are to remain off limits as of today as there is debris and licensee states neighbor is doing construction which is causing dust to come into her yard. The daycare has two fully charged fire extinguishers, however they do not meet the minimum requirements and 210A (larger size) fire extinguisher needs to be purchased, and smoke detectors, and a carbon monoxide (CO) detector in the home. First aid supplies are available. Detergents, cleaning compounds, medications, and other items which could pose a danger to children is stored inaccessible to children. Per Licensee, there are no firearms or weapons in the home. No spas, swimming pools, hot tubs, fish ponds, or similar bodies of water are present. Variety of age appropriate toys and materials is observed in the daycare. A sick child would be separated from the group and wait for parent to pick up. The last emergency disaster drill was conducted on 6/2023 and is appropriately documented. Licensee has expired Pediatric First Aid and CPR certification (exp 9/2022). Staff and children's files reviewed. In the files reviewed, all are incomplete. Licensee and helper have the required staff immunizations: measels (MMR) and pertussis (Tdap). Licensee and helper do not have the mandated child abuse reporter training as compliant with AB1207. All Parent's Rights Form (LIC995) should contain the correct local licensing office address/phone number which is: San Bruno Child Care Regional Office, 851 Traeger Ave, Suite 360, San Bruno, CA 94066 and phone number is (650) 266-8800.

(Continued on next pages 809-C and 809-D)
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Andrea Medlin
LICENSING EVALUATOR SIGNATURE: DATE: 07/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/05/2023
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: TURCIOS, HEYDI
FACILITY NUMBER: 414004782
VISIT DATE: 07/05/2023
NARRATIVE
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LPA 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. Incidental Medical Services (IMS) policy discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is 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: http://www.ada.gov/childqanda.htm. Facility informed that effective September 1, 2016, a person may not be employed or volunteer at a child care 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.

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.

The deficiencies cited on the following pages are in violation of the California Code of Regulations, Title 22, Division 12, Chapter 1. This report is reviewed with facility representative and a copy of this report must be made available for public review upon request.


Notice of Site Visit posted and shall remain posted for 30 days.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Andrea Medlin
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 07/05/2023 05:12 PM - It Cannot Be Edited


Created By: Andrea Medlin On 07/05/2023 at 03:20 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: TURCIOS, HEYDI
FACILITY NUMBER: 414004782

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/05/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)


This requirement is not met as evidenced by: based on review of Pediatric First Aid and CPR it was found to be expired in 9/2022.
Deficient Practice Statement
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The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
POC Due Date: 07/26/2023
Plan of Correction
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Licensee will renew Pediatric First Aid/CPR certification by 7/26/2023 or show proof of enrollment in a course. A return visit will be conducted to verify correction.
Type B
Section Cited
HSC
1596.8662(b)(1)


This requirement is not met as evidenced by: On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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. Licensee and helper do not have the required training.
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in two out of two file reviews which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/26/2023
Plan of Correction
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Licensee and helper will both complete this required mandated child abuse reporter training as compliant with AB1207 by 8/2/2023.
Training can be taken at www.mandatedreporterca.com
A return visit will be conducted to verify correction.
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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Andrea Medlin
LICENSING EVALUATOR SIGNATURE:
DATE: 07/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/05/2023


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/05/2023 05:12 PM - It Cannot Be Edited


Created By: Andrea Medlin On 07/05/2023 at 03:31 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: TURCIOS, HEYDI
FACILITY NUMBER: 414004782

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/05/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417


This requirement is not met as evidenced by: all children's files are incomplete. See LIC 857 - Children's Record Review for a list of what is missing in each child's file.
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in six out of six file reviews which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/26/2023
Plan of Correction
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All files shall be complete by 7/26/2023. A return unanounced visit will be conducted to verify correction.
Type B
Section Cited
CCR
102417


This requirement is not met as evidenced by: Licensee does not have the required fire extinguisher 210AA size.
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in one out of one which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/26/2023
Plan of Correction
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Licensee to purchase a fire extinguisher size 210A for the family child care home. A return visit will be conducted to verify correction.
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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Andrea Medlin
LICENSING EVALUATOR SIGNATURE:
DATE: 07/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/05/2023


LIC809 (FAS) - (06/04)
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