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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004961
Report Date: 03/07/2023
Date Signed: 03/07/2023 12:39:15 PM

Document Has Been Signed on 03/07/2023 12:39 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:AGUILAR - VALENCIA, MARIA GUADALUPEFACILITY NUMBER:
414004961
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
03/07/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Applicant, Maria G. Aguilar-ValenciaTIME COMPLETED:
12:55 PM
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On March 7th, 2023 at approximately at 9am, Licensing Program Analyst (LPA), Leslit Tapia-Mandujano conducted a scheduled Pre-Licensing inspection this day and met with Applicant, Maria G. Aguilar-Valencia. Applicant has applied for a Small Family Child Care License. Present in the home today is applicant, applicant's husband, and applicant's mother, and applicant's two minor children. LPA and applicant inspected entire home for Health and Safety Hazards.

Applicant rents one story (front) duplex home, which is a three bedroom one bathroom home with back and front yard. Applicant lives in the home with adult husband, adult parents, and two minor children. The hours of operation are Monday-Sunday from 8am-5:30pm. Daycare area are: Living Room, Dining Room, Bathroom #1, Bedroom #2, front yard, and backyard. OFF limit areas: Bedroom #1 & #3, Kitchen, Both Side yards. All off limit areas are properly barricaded, including closets.

LPA observed the following: Day-care is clean, orderly with a variety of age appropriate toys for the children. All furniture inspected is in good repair. The applicant has a fully stocked First Aid kit and thermometer. The home has no pools or bodies of water in the home. Per applicant, there are two rosters that are kept in an off limit area. Home has a fireplace is properly barricaded. Per applicant, there are no guns or weapons in the home. The home has age appropriate equipment available for children in care. Applicant was reminded baby walkers, bouncers, jumpers and any other similar items are to not be used for children in care. Discipline policy was discussed. Isolation area for sick child will be in the living room.

The home has sufficient lighting and ventilation. Applicant states they will conduct an emergency drill once every six months and log drills. Applicant's CPR & First Aid expire on 09/2024, Mandated Reporter Training Certificate for applicant expire on 05/2023.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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: AGUILAR - VALENCIA, MARIA GUADALUPE
FACILITY NUMBER: 414004961
VISIT DATE: 03/07/2023
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LPA discussed the safe sleep regulations with applicant 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 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.

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:
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: http://www.ada.gov/childqanda.htm

Applicants husband’s, Jose Ventura and Applicants dad, Baldemar Aguilar exemption approval was discussed. Applicant states they understand the conditions of the Exemption. Licensee knows and understands that if there is any changes, to notify CCLD.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA will recommend licensure for Small Family Child Care License as of today, March 7th, 2023.

Exit interview conducted and report was reviewed with the applicant, Maria G. Aguilar-Valencia..
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023
LIC809 (FAS) - (06/04)
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