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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004848
Report Date: 03/24/2023
Date Signed: 03/24/2023 03:56:02 PM

Document Has Been Signed on 03/24/2023 03:56 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:SOUSA, FRANCIELE LOPES DEFACILITY NUMBER:
414004848
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
03/24/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Gabriel SantosTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with facility representative for this case management visit today. Facility has requested to increase capacity to a large family child care home (FCCH). There are 4 children present during the visit; 3 infants and 1 preschool aged. The South San Francisco Fire Department has approved the fire clearance on 2/27/2023. Days and hours of operation: Monday-Friday 7:30AM--5:30PM. Licensee states she and husband are only ones living in the home; criminal record clearance is on file for all adults. Physical plant toured to inspect for health and safety hazards. The home has smoke detectors, a fully charged fire extinguisher, and a carbon monoxide (CO) detector in the home. Outdoor space inspected for health and safety hazards; outdoor play area is completely fenced. First aid supplies are available. Detergents, cleaning compounds, medications, and other items which could pose a danger to children is stored inaccessible to children. The daycare areas are kept clean and orderly and has adequate heating and ventilation for safety and comfort. Per Licensee, there are no firearms or weapons in the home. There is one cat 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. Licensee has current Pediatric First Aid and CPR training (exp. 7/2023) and 8 hours health and safety training. Licensee has proof of the mandated child abuse reporting training as compliant with AB 1207 (exp 7/2023), and verification of the required immunizations: measels and pertussis. All the required licensing forms are posted; new license will be posted when received. If Licensee provides care to the 13th and 14th child, children must be school aged (6 years or older), and Parent Notification is required.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Andrea Medlin
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2023
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SOUSA, FRANCIELE LOPES DE
FACILITY NUMBER: 414004848
VISIT DATE: 03/24/2023
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This home meets the licensing requirements of a Large Family Child Care Home today and licensure is recommended and approved as of today, 3/24/2023.

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: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
LIC809 (FAS) - (06/04)
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