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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005199
Report Date: 01/29/2025
Date Signed: 01/29/2025 12:28:34 PM

Document Has Been Signed on 01/29/2025 12:28 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:OLAZABAL, DEYSI MARGARITAFACILITY NUMBER:
414005199
ADMINISTRATOR/
DIRECTOR:		OLAZABAL, DEYSI MARGARITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 450-1983
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 0DATE:
01/29/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Applicant, Deysi Margarita OlazabalTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On January 29th, 2025 at approximately 9:20am, Licensing Program Analyst (LPA), Tapia-Mandujano conducted a scheduled Pre-Licensing inspection this day and met with Applicant, Deysi Margarita Olazabal. Applicant has relocated from previously licensed facility #: 414004980. Applicant has applied for a Small Family Child Care Home License. Present in the home today is applicant.

Applicant rents a one-story level house with three-bedroom, one bathroom home with detached garage. Applicant lives in the home with minor children. The hours of operations will be from Monday-Friday from 8am-5pm. The ages that applicant plans to care for are ages 3 months to 5 years old. All adults living in the home have obtained fingerprint clearance and are associated. LPA and applicant inspected entire home for Health and Safety Hazards.

Daycare areas are: Living Room, Dining Room, Bathroom #1, Fence portion (left) of backyard. OFF limit areas are: Bedroom #1-#3, Kitchen, Detached Garage, Side yards, Fenced portion (right) of the Backyard, Front Yard, Side Yards, and Driveway. All off-limit areas are properly barricaded, including all closets.

LPA observed the following: Daycare Area is still being set up. Applicant understands in order to get licensed all day care areas must be fully set up and free of hazards. Home has sufficient light and ventilation. All furniture inspected is in good repair. The applicant will have a fully stocked First Aid kit. The home has no pools or bodies of water. Per applicant, there are pets in the home with proper documentation. Home does have a fireplace that 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 dining room area.

Applicant acknowledges they will conduct an emergency drill at least once every six months and log drills. Applicant’s CPR & First Aid certificate will expire on 01/2026 and Mandated Reporter Training Certificate will expire on 11/2026.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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 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: OLAZABAL, DEYSI MARGARITA
FACILITY NUMBER: 414005199
VISIT DATE: 01/29/2025
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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, 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 licensed Family Child Care Home. 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.

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) or (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.

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.

LPA discussed the safe sleep regulations with applicants 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 applicant 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: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC809 (FAS) - (06/04)
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: OLAZABAL, DEYSI MARGARITA
FACILITY NUMBER: 414005199
VISIT DATE: 01/29/2025
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On this date, 1/13/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Prior to LPA approving Small Family Child Care Home, applicant must submit proof of the following corrections:
*Daycare Areas must be fully set up and be clean.
*Living Room cables must be covered/secured
*Off limits areas properly barricaded by child’s gate
*Safety locks installed in kitchen and bathroom
*Backyard to be free of any potential hazards
*Required postings to be posted in a prominent area
*Updated LIC 999A

Exit interview conducted and report was reviewed and translated into Spanish by LPA Tapia-Mandujano with the applicant, Deysi Margarita Olazabal.

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 platforms.

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

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC809 (FAS) - (06/04)
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