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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004961
Report Date: 04/03/2024
Date Signed: 04/03/2024 06:09:51 PM

Document Has Been Signed on 04/03/2024 06:09 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:AGUILAR - VALENCIA, MARIA GUADALUPEFACILITY NUMBER:
414004961
ADMINISTRATOR:
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
04/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
TIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Licensee, Maria Guadalupe Aguilar-ValenciaTIME COMPLETED:
TIME VISIT/
INSPECTION COMPLETED:
06:30 PM
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On April 3rd, 2024, at approximately 2:30pm, Licensing Program Analyst (LPAs) Tapia-Mandujano and Alvarado arrived at the facility to conduct an annual inspection and an Case Management initiated by licensee. LPAs explained the purpose of the inspection. LPAs met with licensee, Maria Guadalupe Aguilar-Valencia. Present in the facility were licensee and licensee's assistants supervising 8 children (4 infants and 4 preschool age). Facility is not operating within capacity limits on this day (Deficiency was received). All adult living and working in the home are fingerprint cleared and associated.

During inspection, licensee left and picked up two school age children. By the time the school age children arrived, there were 2 infants, 2 preschoolers, and 2 school-age children.

Licensee has requested to expand license to a Large Family Child Care Home. Fire Clearance was received by Redwood City Fire Department on 3/21/24. During today's inspection, LPAs went over Capacity limitations with licensee. Licensee also received a copy of an updated Floor Plan. Licensee has also requested to approve Bedroom #3. LPAs observed bedroom #3 was not set up and prior to approval, Bedroom #3 has to be set up.

Licensee rents one story (front) duplex home, which is a three bedroom one bathroom home with back and front yard. Licensee lives in the home with adult husband, adult parents, and four minor children. The hours of operation are Monday-Sunday from 6am-7pm. 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.

LPAs toured day care areas of home with Licensee to inspect for health and safety hazards. LPAs observed home to be clean and in good repair with proper temperature and ventilation. There were a variety of age appropriate toys and equipment in the home which were in good condition. Home has a fireplace and an open face heather that are properly barricaded. Licensee does not have any pets. There are no pools, and bodies of water in the premises. LPAs reminded licensee about the importance of water safety. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Discipline Policy was discussed. Infant children sleep in pack and plays in the family room.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2024
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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Document Has Been Signed on 04/03/2024 06:09 PM - It Cannot Be Edited


Created By: Leslit Tapia-Mandujano On 04/03/2024 at 04:14 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: AGUILAR - VALENCIA, MARIA GUADALUPE
FACILITY NUMBER: 414004961

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(a)
Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above as there was 4 infants and 4 preschool age children present upon LPAs arrival which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/04/2024
Plan of Correction
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Facility must reduce capacity to the maximum number of children for whom care may be provided at any given time. At any given time there could be 4 infants only, or 3 infants and 3 preschoolers, or 2 infants, 4 preschoolers, and 2 school age children.

Licensee will submit proof of a schedule of children to prove that facility is not operating overcapacity.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Marie Rodriguez
LICENSING EVALUATOR NAME:Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024


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: AGUILAR - VALENCIA, MARIA GUADALUPE
FACILITY NUMBER: 414004961
VISIT DATE: 04/03/2024
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There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed for Licensee is current. Per Licensee, there are no weapons/firearms in the home. LPAs reviewed 7 children's' record which were complete. LPAs also reviewed facility and employee records. Licensees CPR & First Aid Certificate will expire 09/2024. Licensee's Mandated Reporter will expire on 03/2025. Last Emergency drill was conducted 10/25/23. Licensee will need to conduct an emergency drill by 4/25/24. Emergency drills must be conducted at least once every six months and should be properly logged.

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 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.

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 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.


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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
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: AGUILAR - VALENCIA, MARIA GUADALUPE
FACILITY NUMBER: 414004961
VISIT DATE: 04/03/2024
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Incidental Medical Services (IMS) policy was discussed. Licensee does not have any children enrolled who use medication. 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/.

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, Maria Guadalupe Aguilar-Valencia confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS on 04/03/2024.

Deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1. Refer to LIC 809D for more details.

LPAs informed licensee Maria Guadalupe Aguilar-Valencia that this report dated 04/03/24 documents a Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPAs informed the licensee Maria Guadalupe Aguilar-Valencia to provide a copy of this licensing report dated 04/03/24 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report was reviewed with licensee, Maria Guadalupe Aguilar-Valencia.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
LIC809 (FAS) - (06/04)
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