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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005228
Report Date: 10/03/2025
Date Signed: 10/03/2025 04:08:21 PM

Document Has Been Signed on 10/03/2025 04:08 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:MI SECOND CASAFACILITY NUMBER:
414005228
ADMINISTRATOR/
DIRECTOR:		MICHAEL TEJADAFACILITY TYPE:
860
ADDRESS:847 N. SAN MATEO DRIVETELEPHONE:
(650) 218-2166
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY: 40TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/03/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Michael TejadaTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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On October 3, 2025 at approximately 9:00am, Licensing Program Analyst (LPA) Catrina Quimbo and Maria Olguin-Leon conducted a scheduled, pre-licensing visit to Mi Second Casa. LPAs met with applicant, Michael Tejada, and explained the purpose of the visit. Present during visit included co-owner, Miguel Tejada.

Applicant is requesting for a total capacity of 40 children: 8 infants (3 months to 18 months), 12 toddlers (18 months to 36 months) and 20 preschoolers (3 years to 5 years old). Fire clearance for 40 children was received September 25, 2025.

The program will operate Monday through Fridays 8:00am to 5:00pm. The facility is a multi-level facility that includes 1 infant room, 1 toddler room, 3 preschool classrooms, 1 gross motor room, 3 children's restrooms, kitchen, director's office, staff room and 2 outdoor areas. The designated director for the program will be Michael Tejada.

Infant component will operate in the "Conejitos" room (ground level). Toddler component will operate in the "Pajaritos" room (ground level). The preschool component will operate in the "Mariposas" (ground level), "Ositos" (second level), "Manzanitas" room (second level), and the "Fiesta" gross motor room (second level).

LPAs inspected the areas for health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met.

Infant Indoor measurements are:
The infant indoor measurements contain a total of 286.97 square feet which will accommodate applicant's request for 8 infant children.

Toddler Indoor measurements are:
The toddler indoor measurements contain a total of 547.48 square feet which will accommodate applicant's request for 12 toddler children.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2025
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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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)
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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: MI SECOND CASA
FACILITY NUMBER: 414005228
VISIT DATE: 10/03/2025
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Preschool Indoor measurements are:
The preschool indoor measurements contain a total of 1,672.48 square feet which will accommodate applicant's request for 20 preschool children. There is a gross motor "fiesta" room on the second level of the facility that will be for preschool use only. The "fiesta" room measured for 434.81 square feet. Due to the room being an indoor gross motor room, it is not counted towards total indoor capacity.

Preschool Outdoor measurements are:
The preschool outdoor measurements are 2,534.38 square feet which accommodate applicant's request for 20 preschool children.

Infant Outdoor measurements are:
The infant outdoor measurements contain a total of 942. 81 square feet which will accommodate applicant's request for 8 infant children. Infant outdoor area will be shared among the toddler and infant components. The infant outdoor measurements will accommodate applicant's request for 12 toddlers.

The child care center was observed to be clean, sanitary and in good repair. A comfortable temperature for children is being maintained. Furniture and equipment were observed to be maintained in good condition. Tables and chairs are age appropriate. LPAs observed closets' door handles to have child safety knobs installed. There are rugs in classrooms that were observed to be clean and new. Per applicant, rugs will be vacuumed daily. LPAs observed infants' materials to be appropriately stored in bins.

There are children's restrooms on the ground floor and second level of the facility. LPAs observed restrooms to be in working condition. Sinks accessible to children do not provide water that is warmer than 120 degrees Fahrenheit. LPAs observed garbage bins with tight fitting lids through the facility.

Sinks and toilets:
There are 9 sinks, 5 toilets and 2 urinals which will accommodate the applicant's request for 40 children.

There is a diaper changing table on site for the infant component, that is within arm's reach to an adult sink. Diapering sinks are not used for meal preparation or dishwashing. Per applicant, diapers and wipes will be provided by children's families. LPAs observed storage for children's diapers to be appropriate. LPAs observed changing tables to be equipped with moisture resistant material and with sides of the changing tables that are at least 3" high.

Children will nap in their designated classrooms. Infant component children will sleep in cribs. LPAs observed cribs to be free of loose articles, materials and objects. LPAs observed infants' napping area to be physically separate from the infants' activity area. LPAs reminded applicant of regulations for a wall partition.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2025
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: MI SECOND CASA
FACILITY NUMBER: 414005228
VISIT DATE: 10/03/2025
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Infants who are able to climb out of a crib will sleep on a cot. Toddler and preschool children will also sleep on cots. Per applicant, sheets and blankets will be provided by children's families and will be stored in their designated cubbies so that they are not touching each other.

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-andresources/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.

Facility is equipped with a fire alarm system, multiple first aid kits, multiple fully charged fire extinguishers, and multiple smoke detectors. Per applicant, detectors are combination of smoke and carbon monoxide. When medications are on site, they will be stored in the child's designated classroom, in a high shelf.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes 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

Licensing documents are posted in main entrance of facility, available for review. Children will be signed in and out of program with electronic signatures through an electronic application. Per applicant, each authorized representative will have a unique electronic code that acts as the individual's signature. There is sufficient cubby space for children's personal belongings. Isolation area will be in the applicant's office. There are separate adult restrooms on site, when needed

Outdoor areas between the preschool and infant children are physically separate from one another. Entire outdoor area is fully fenced and enclosed. Applicant plans for the toddler component to share the infant component outdoor area on a rotation schedule. LPAs advised applicant a waiver request will be needed.

Outdoor areas have a variety of outdoor toys and materials that are in good condition. Flooring in both outdoor areas include artificial turf and concrete. Preschool area includes a sandbox that is covered when not in use. Preschool area also includes climbing structures with sufficient padding underneath. Infant area includes crawling tunnels. There is sufficient shade in the outdoor area. LPAs did not observe any pools, spas or bodies of water on site.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2025
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: MI SECOND CASA
FACILITY NUMBER: 414005228
VISIT DATE: 10/03/2025
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Program will provide a food service that includes morning snack, lunch and afternoon snack. Both reusable and disposable dishes will be utilized. Applicant plans to install a dishwasher in the kitchen for sanitization. Food preparation will be conducted in facility's kitchen that includes a freezer and portable oven. Drinking water will be available with children's individual water bottles that will labeled with their individual names. There are accessible drinking fountains on site.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA reviewed with applicant, the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.



Applicant was informed of the MyChildCarePlan.org site, 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.

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 athttps://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication

Applicant and facility representative were reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides 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 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.

Applicant was reminded infant, toddler and preschool component children must be kept physically separate and cannot co-mingle with one another. Applicant was also reminded toddler component children must have written permission/consent from their authorized representatives to participate in toddler component. Applicant was also reminded infant children must have an infant needs and services plan that must be updated with infants' families, quarterly.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: MI SECOND CASA
FACILITY NUMBER: 414005228
VISIT DATE: 10/03/2025
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Facility will be approved for a total capacity of 40 children: 8 infants, 12 toddlers and 20 preschoolers when following is complete:

-Wall partitions for infant's napping space updated to Title 22 regulations.
-Installation of child safety gate on the outdoor area stairs.
-Installation of sound alarm system on exit doors in the infant classroom, toddler classroom, and preschool classrooms.
-Submission of outdoor waiver request with outdoor rotations.
-Centralized Application Bureau (CAB) final approval of application.
-Management approval.

Applicant, Michael Tejada, understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.

Exit interview conducted and report was reviewed with the applicant, Michael Tejada.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2025
LIC809 (FAS) - (06/04)
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