414005206-2-7-2025-05-CC-DALO-DDP299-20250207161135

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414005206
Report Date: 02/07/2025
Date Signed: 02/07/2025 04:11:57 PM

Document Has Been Signed on 02/07/2025 04:11 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:	QUINTERO, ROSALBA		FACILITY NUMBER:	414005206
ADMINISTRATOR/ DIRECTOR:	QUINTERO, ROSALBA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 568-0499
CITY:	SOUTH SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	02/07/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:29 AM
MET WITH:	Rosalba Quintero		TIME VISIT/ INSPECTION COMPLETED:	04:45 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 February 7, 2025, at approximately 8:30am, Licensing Program Analyst (LPA) Alvarado, conducted a scheduled relocation pre-licensing visit. LPA met with applicant, Rosalba Quintero, and explained the purpose of the visit. Applicant submitted a relocation application to our department on January 24, 2025. Applicant is in the process of relocating from Facility #414004665 to this location. Present during the visit was the applicant. Applicant rents a two-story home that consists of 3 bedroom, 2 bathrooms, with back yard, and a garage. Applicant lives in the home with daughter, and minor daughter. The Department has transferred fingerprint clearance and associated to current license on 2/7/2025. DAY CARE AREAS: Living room (Main Day Care Area), Bedroom #1, Bathroom #1 (Located on the Second Floor only for Family Child Care Home bathroom use), Outdoor Deck and Side Play areas that are fenced in on the left and right side of the deck. OFF LIMIT AREAS: Entire second Floor(Bathroom only for Family Child Care Home use), Kitchen, Garage, Bathroom #2 located in the Garage, side patio of the garage on the left, and the storage Home in the back. The hours of operation are 24 hours, Monday-Friday. LPA explained to the applicant that a child cannot exceed 24 hours care at any given time. Applicant plans to provide cots and playpens for children to rest and nap on. Parents will provide blankets and applicant will wash blankets and sheets once a week. LPA informed applicant that cribs for napping infants must be free of loose articles, materials, and objects. LPA informed applicant that cribs for napping infants must have a mattress with a tight-fitting sheet only. Safe sleep was discussed with applicant. Continued on Page 2...

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: QUINTERO, ROSALBA	FACILITY NUMBER: 414005206
	VISIT DATE: 02/07/2025

NARRATIVE

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With applicant Rosalba Quintero, LPA inspected the entire home for health and safety hazards. LPA observed the day care areas to be clean and safe. LPA observed day care areas to be equipped with a variety of age-appropriate toys, materials, and furniture that are in good working condition. Flooring in home includes wood floors that were observed to be clean and free of stains. There are off limit rooms that include a child safety door handle. LPAs observed electrical outlets to be made inaccessible with child safety covers. LPA observed off limit areas to be properly barricaded. LPA observed the stairs to the second floor to be properly barricaded making it inaccessible. LPA observed the small steps outdoors by the deck to be barricaded.

Home includes multiple duo smoke and carbon monoxide detectors. Applicant tested detectors in the living room, that was observed to be working. Home includes a fully charged 2-A:10-B:C fire extinguisher. Per applicant, there are no weapons or firearms in the home. Home has a fireplace that is properly barricaded with a large furniture piece, LPA suggested a fireplace screen to ensure full inaccessibility to the fireplace. Home also has vents throughout the home that have been properly covered by furniture pieces. Bathroom sink and toilet was observed to be in proper working condition. LPAs did not observe any accessible poisons, chemicals or other hazardous materials in bathroom's cabinets.

LPA did not observe pools, wading pools, hot tubs, spas, fishponds or similar bodies of water on the property. Applicant also confirmed that no similar bodies of water on the facility property.

Applicant was reminded baby walkers, bouncers, jumpers, and any other similar items are not to be used for children in care. LPA reminded applicant emergency disaster drills are to be conducted and documented at least once every six months.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

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: QUINTERO, ROSALBA	FACILITY NUMBER: 414005206
	VISIT DATE: 02/07/2025

NARRATIVE

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Applicant's CPR/First Aid certification is current and will expire 10/2025. LPA reminded applicant CPR/First Aid training and Mandated Reporter training must be renewed every two years. Applicant was also reminded Mandated Reporter training must be renewed every two years by all staff working with children.

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.

The applicant provided control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

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: QUINTERO, ROSALBA	FACILITY NUMBER: 414005206
	VISIT DATE: 02/07/2025

NARRATIVE

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LPAs 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 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.

On this date, 2/7/2025, 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 childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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-carelicensing/ subscribe and select the Child Care option to receive email communication.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

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: QUINTERO, ROSALBA	FACILITY NUMBER: 414005206
	VISIT DATE: 02/07/2025

NARRATIVE

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Prior to licensure, following is to be completed:
-Completed Mandated Reporter Training
-Licensing board to be posted with all appropriate documents.
-Proof of Influenza or Declination of Influenza
-Photos of Napping Equipment
-Updated LIC 610 (be sure to obtain permission from the property owner)
-Photo of Emergency Kit

Exit interview conducted and report was reviewed with the applicant, Rosalba Quintero

This Report was Translated in Spanish by LPA Alvarado

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

LIC809 (FAS) - (06/04)

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