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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004800
Report Date: 07/14/2022
Date Signed: 07/14/2022 03:03:33 PM

Document Has Been Signed on 07/14/2022 03:03 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:JAMESON, GLORIAFACILITY NUMBER:
414004800
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
07/14/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Gloria Cristina JamesonTIME COMPLETED:
03:15 PM
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On July 14, 2022 at approximately 12:40pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, case management inspection. LPA met with licensee, Gloria Cristina Jameson, and explained the purpose of the inspection. Present in the home were licensee, licensee's mother, and 6 enrolled children (3 infants and 3 preschool age). Facility is operating within capacity limits and ratio at time of LPA's visit. All adults living and/or working in the have have fingerprint clearance on file.

Licensee rents the home and is currently licensed for a small family child care home. The licensee applied for a large family child care home license on May 10, 2022. The home received a fire clearance June 13, 2022.

Hours of operation are Monday to Friday 7:30am to 5:00pm. Licensee lives in the home with minor child. The home consists of 3 bedrooms, 2 bathrooms, living room, dining area, kitchen, garage and backyard area. The DAY CARE AREAS are the living room, dining area, bedroom #1 (napping room), bathroom #1, and half of the backyard area. The OFF-LIMITS AREAS are the kitchen, bedroom #2, bedroom #3, bathroom #2, garage, and other half of backyard area. All off limit areas are properly barricaded with child safety gates and/or child safety proof handles.

LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of age appropriate toys that were in good condition. Outdoor area is equipped with age appropriate toys and materials that were also in good working condition. There were no pools, spas or bodies of water on the property. All cleaning supplies, poisons, other chemicals and sharp objects were stored inaccessible to children on facility's high shelves.



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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: JAMESON, GLORIA
FACILITY NUMBER: 414004800
VISIT DATE: 07/14/2022
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LPA observed a fully charged fire extinguisher, smoke/carbon monoxide detectors, and working phone on site. Per licensee, there are no weapons or pets in the home. Garbage cans have tight fitting lids. The home contains a fireplace that is properly barricaded by furniture.

Capacity limits and ratios for a large family day care have been reviewed with licensee on this date. LPA reminded licensee that an assistant must be present when operating as a large license. LPA reminded licensee when an assistant is not present, licensee must operate as a small license.

After today's visit, no deficiencies were cited.

A large license has been recommended for facility effective 07/15/2022.

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

Exit interview conducted and report was reviewed with licensee, Gloria Cristina Jameson.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
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