<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004907
Report Date: 09/18/2025
Date Signed: 09/18/2025 06:01:10 PM

Document Has Been Signed on 09/18/2025 06:01 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:AFTERSCHOOL CARE ENRICHMENT (ACE) @ HEATHERFACILITY NUMBER:
414004907
ADMINISTRATOR/
DIRECTOR:		PUCCINELLI, NICHOLASFACILITY TYPE:
840
ADDRESS:2757 MELENDY DRIVETELEPHONE:
(650) 453-3429
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY: 75TOTAL ENROLLED CHILDREN: 96CENSUS: 75DATE:
09/18/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:25 PM
MET WITH:Site Director, Tawny PeekTIME VISIT/
INSPECTION COMPLETED:
06:20 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 September 18th, 2025, at approximately 2:25pm, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced Case Management-Licensee initiated inspection. LPA was greeted by Site Director, Tawny Peek and explained the purpose of the inspection. Executive Directors, Eve Daskalakis and Nick Puccinelli arrived shortly after during the inspection. LPA explained the purpose of the inspection to executive directors.

Present in the facility were Site Director and 6 staff supervising 75 school age children. All adults present are fingerprint cleared and are associated to the facility.

Department received a room change and increase of capacity application on August 6th, 2025. Facility is requesting to increase capacity from 75 to 95 children and to move from Rooms 19 and Room 25 for school age children ages 4 to 12. Fire clearance was approved and signed by Redwood City Fire Department on 8/26/25.

Facility is located at Heather Elementary School. Facility is currently licensed in Room 17 and 18, Multiuse room, Lower playground, Baseball field, baseball field, basketball court, and upper playgrounds.

During today’s inspection, LPA observed that the facility is using the requested rooms of 19 and 25 prior to approval by licensing department, Type B citation was received.

Hours of operation are Monday through Friday 7:30am to 9:30am and/or 12:00pm-6:00pm. Children are signed into and out of the program manually. A staff signs in the children and parents sign out the children authorized representatives.

LPA inspected rooms 19, 25, and Multiuse Room with Executive Directors. Facility installed a portable sink in Room 25 that will be used for prepping food. Facility also has a water dispenser that is being serviced for drinking water and used for portable sink. Room 19 has a faucet that will only be used for hand washing. Staff will take a jug of water to have water readily available for children in Room 19. Room 25 has one toilet and one sink for children. There are two separate bathrooms available for boys and girls next to the Multiuse room and lower playground with toilets and sinks that are in working conditions.

Continued on Page 2...

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Leslit Tapia-Mandujano
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2025
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
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: AFTERSCHOOL CARE ENRICHMENT (ACE) @ HEATHER
FACILITY NUMBER: 414004907
VISIT DATE: 09/18/2025
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
26
27
28
29
30
31
32
Page 2 Continued...

LPA observed each classroom is equipped with age-appropriate furniture that was in good working condition. LPA observed a carbon monoxide detector and smoke alarm in each classroom. LPA observed each classroom to include a fire alarm system and fully charged fire extinguisher. Storage for children's belongings are located outside of Room 25.

All poisons, cleaning solutions and hazardous materials are stored inaccessible to children in off limit areas or facility high shelves. Facility provides snacks for children enrolled. Children also bring their own individual drinking bottles that are refilled as needed. Water is available to children indoors and outdoors.

Outdoor area appears to be clean and orderly. There are a variety of outdoor equipment that appear to be in good working condition. Facility has license documentation and information properly posted and available for review.

During today’s inspection, LPA received the following documents: Letter of Intent, LIC 200A, LIC 610, Sketch of overall campus, Admission Agreement, Lease Agreement, Parent Handbook, and Job Descriptions.

Facility representative was reminded that all adults 18 and over, 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 Child Care Center. 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/.

Prior to approval of increase of capacity and room change application for rooms 19 and 25, facility must submit the pending documentation that were discussed.

Based on today's inspection, deficiencies were observed, according to California Title 22, Health and Safety Code of Regulations.

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

Exit interview conducted and report was reviewed with Site Director, Tawny Peek.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Leslit Tapia-Mandujano
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 09/18/2025 06:01 PM - It Cannot Be Edited


Created By: Leslit Tapia-Mandujano On 09/18/2025 at 05:45 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: AFTERSCHOOL CARE ENRICHMENT (ACE) @ HEATHER
FACILITY NUMBER: 414004907

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/17/2025
Section Cited
CCR
101173(c)

1
2
3
4
5
6
7
101173: Plan of Operation: (c) Any proposed changes in the plan of operation that affect services to children shall be subject to departmental approval prior to implementation and shall be reported as specified in Section 101212.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Facility has a pending application requesting room changes to the facility.

8
9
10
11
12
13
14
Based on observation and record review, the licensee did not comply with the section cited above as the facility is using rooms that have been requested to change but is still pending final approval from licensing department which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Facility will submit all pending documentation to finalize the application for room change.

All paperwork must be submitted to LPA Tapia-Mandujano by 10/17/25.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Leslit Tapia-Mandujano
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2025


LIC809 (FAS) - (06/04)
Page: 4 of 4