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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004807
Report Date: 08/16/2023
Date Signed: 08/16/2023 04:40:46 PM

Document Has Been Signed on 08/16/2023 04:40 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:LEIB, HAUDY A.FACILITY NUMBER:
414004807
ADMINISTRATOR:LEIB, HAUDY A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(732) 763-4450
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
08/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:41 PM
MET WITH:Haudy LeibTIME COMPLETED:
04:55 PM
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On August 16, 2023, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Haudy Leib for an unannounced annual inspection. The purpose of the inspection was explained. Present today was Licensee, two helpers, granddaughter and 7 children (3 infant & 4 preschool age). All adults have criminal record clearances on file with the department. Licensee is operating within capacity and ratio requirements on this day. Hours of operation are Monday– Friday, 7:30am to 5:30pm, extended care 5:30pm -10:30pm and Saturday 10:00am – 6:00pm.

LPA and Licensee toured the home for health and safety hazards. Licensee rents this two-story home.
Day Care Areas: The entire first floor and backyard are used for daycare; 1st floor bedroom is used for napping purposes only. Off Limits Areas: Entire 2nd floor, bathroom in bedroom on first floor and garage. All cabinets are properly secured with childproof latches. Home is well light and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. The staircase is equipped with a childproof gate. There are plenty of age-appropriate toys, books, child size furnishings, learning material,playpens and sleeping cots. Backyard has plenty of age-appropriate play toys, trampoline, riding toys and play kitchen. Backyard has a cement patio and real and artificial grass to cushion falls. LPA observed a water canal located behind backyard and is properly fenced with a 3 ft. wood fence and green mesh. Gate to canal is equipped with a lock. Canal is inaccessible to children in care. Sides of home is fenced off with a 5 ft. fence.

Home is equipped with a working carbon monoxide detector, smoke detectors, fire alarm system and a fully charged fire extinguisher. Isolation area for ill children will be in dining area and away from other children. First aid kit is fully stocked with supplies. Licensee uses a cell phone on the premises. Per licensee there are no weapons or firearms in the home. Parents provide sheets for sleeping cots/playpens and are washed weekly or when soiled.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2023
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: LEIB, HAUDY A.
FACILITY NUMBER: 414004807
VISIT DATE: 08/16/2023
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LPA reviewed 5 children’s records and two staff record; all required documents were in children’s files. Licensee Mandated Reporter training has expired, technical assistance was cited. Licensee’s CPR/First Aid is current and will expire on 09/2023. Children bring meals from home. LPA reminded Licensee to label children's food containers brought from home. Facility provides snacks. LPA reminded Licensee to keep children’s roster up to date. LPA observed Childcare License, Emergency Disaster Plan (LIC610A) and Parent's rights posted. Last emergency drill was conducted on 06/08/2023 and is properly documented. Per licensee, she has liability insurance.

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.

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/.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare 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. LPA reviewed AB 1207 with the Licensee.

Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023
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: LEIB, HAUDY A.
FACILITY NUMBER: 414004807
VISIT DATE: 08/16/2023
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As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com

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-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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. LPA discussed sleeping sacks.

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

As of today, no deficiencies were issued under CCR, Title 22, Division 12.

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

Exit interview conducted and report was reviewed with the licensee Haudy Leib.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023
LIC809 (FAS) - (06/04)
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