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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005100
Report Date: 06/10/2026
Date Signed: 06/10/2026 11:03:13 AM

Document Has Been Signed on 06/10/2026 11:03 AM - 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:MONTECINOS, NORMAFACILITY NUMBER:
414005100
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
06/10/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:24 AM
MET WITH:Licensee, Norma Montecinos TIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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 June 10th, 2026 at approximately 8:30AM, Licensing Program Analyst (LPA) Alvarado conducted an unannounced inspection for increase of capacity today and met with licensee, Norma Montecinos(L1) for the request to increase capacity from a Small to a Large Family Child Care License. Present in the home are (L1) and assistant caring for 2 children (1 infant and 1 preschool age), Shortly after 3 More children arrived to the facility with a total of (L1) and assistant supervising (2 infants and 3 preschool age). During today’s inspection, Facility is operating within Ratio and capacity. All adults living and working in the home have fingerprint clearance and are associated to the facility.

On May 29th, 2026 (L1) submitted an application to the department for an increase of capacity, from a small to a large license. Fire Clearance was received by the South San Francisco Fire Department on June 3rd, 2026. (L1) has at least one year of Family Child Care Home (FCCH) experience.

The home is a one-level home that consists of 3 bedrooms, 2 bathrooms, living room, dining area, kitchen, garage, and backyard. Facility hours of operation are Monday-Friday 8:00AM-5:00PM. LPA along with (L1) inspected day care areas for health and safety hazards.

DAY CARE AREAS are the living room, dining room, bathroom #1, bedroom #1, (garage for walk through to backyard Only), and backyard.

OFF-LIMIT AREAS are bedroom #2, bedroom #3, bathroom #2, and garage. Off limit areas are made inaccessible with child proof safety gates and child safety locks.

LPA observed day care area to be clean, orderly and in good repair. LPA observed age-appropriate toys and learning materials to be present.

Continued on Page 2...
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2026
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 3
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 3
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: MONTECINOS, NORMA
FACILITY NUMBER: 414005100
VISIT DATE: 06/10/2026
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...
Off-limit areas were observed to be properly barricaded. Facility has a fireplace that is located in the living room that was observed to be properly inaccessible to children in care. There Is a fully charged fire extinguisher located in living room. Capacity limits of a Small and Large Family Child Care Home were explained. Per (L1) there are no firearms present in the facility. All chemicals and Poisons are locked and made inaccessible to children. No pools, hot tubs, spas, fishponds or similar bodies of water observed on the property. (L1) also confirmed there were no bodies of water on property. (L1) was reminded that Baby-walkers, bouncers, jumpers and similar items will not be used for children in care and are not allowed. Capacity limits of a Small and Large Family Child Care Home were explained. A copy of the Capacity Regulations for a Family child Care Home License Chart was provided to (L1).

APPLICANT RENTS/LEASES THE HOME AND HAS LANDLORD CONSENT: Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

During today’s inspection LPA also conducted 5 children records reviews for the present children. LPA observe that (L1) had the Individual Infant Plan (LIC 9227) and LPA was able to confirm Infant 15-Minute Sleep Logs for current enrolled infants in care. LPA reviewed two personnel records where (L1) has Mandated Reporter Training that is current Expiring 11/2026 and has Current Pediatric First Aid/CPR Expiring 5/2027. Current Assistant has Mandated Reporter Training that is current Expiring 5/2028. Assistant does not have current Pediatric First Aid/CPR. Per (L1), assistant recently just started at the facility as of the week. LPA reminded (L1) that Pediatric First Aid/CPR and Mandated Reporter Training need to be renewed every two years and for all assistants who are providing care and supervision to children.

LPA will recommend for approval of a Large Family Child Care Home License as of today, June 10th, 2026.(L1) was reminded when operating as a Large a qualified Assistant must be present if not Facility must operate as a small License Capacity.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

See LIC9102-TV for Technical Violation regarding Personnel Requirements.

A notice of site visit was given and must remain posted for 30 days. (L1) was provided with appeal rights.

Exit interview was conducted and report was reviewed by licensee, Norma Montecinos.
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026
LIC809 (FAS) - (06/04)
Page: 3 of 3