414005363-6-17-2026-05-CC-MOLN-DV5P9M-20260617110718

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414005363
Report Date: 06/05/2026
Date Signed: 06/17/2026 11:08:45 AM

Document Has Been Signed on 06/17/2026 11:08 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:	GONZALEZ, KAREN		FACILITY NUMBER:	414005363
ADMINISTRATOR/ DIRECTOR:	GONZALEZ, KAREN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 533-8173
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 3	CENSUS: 0	DATE:	06/05/2026
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:10 PM
MET WITH:	Karen Gonzales		TIME VISIT/ INSPECTION COMPLETED:	02:45 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 January 6, 2026 @ approx. 12:10 pm, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an announced, pre-licensing relocation inspection visit. LPA met with Licensee Karen Gonzalez and explained the purpose of the inspection. Licensees previous license was #414004550. Applicant submitted a relocation large childcare home application on May 12, 2026. Fire inspection clearance was received in Regional Office on June 4, 2026. Licensee’s hours of operation will be Monday-Friday 8:00 am – 6:00 pm. Applicant plans to provide care for children ages 0 months to 6 yrs. old. Present during today’s visit was Licensee only With licensee, LPA inspected the indoors and outdoors of home for health and safety hazards. Licensee owns and lives in the home with spouse and 2 minor children. Home consists of 4 bedrooms, 3 bathroom, living room, kitchen, dining room/family room, laundry nook, garage and side/back yard. The DAY CARE AREAS: are living room, bedrooms #1, bathroom#1, laundry nook and side yard/backyard. The OFF-LIMITS AREAS: kitchen, dining room/family room, bedrooms #2, #3, Master bedroom #4, bathroom #2 & #3, garage and backyard deck. The ISOLATION AREA: will be in bedroom #1 where an adult can supervise all children in care and keep sick child away from other children. The applicant was notified that any off-limit areas are not to be used as a day care area without prior approval from department. LPA observed that the home was clean and orderly with proper temperature and ventilation. Living room is equipped with toy storage cubbies, child size table and chairs, learning materials, and bookshelf. Per Licensee, pack n plays used for sleeping are still at old address and will bring them over once approved for relocation. Licensee provides sheets for playpens and will wash weekly or as needed. LPA observed the off-limits area of home to be secured with a sliding door which is between kitchen and laundry nook. Bathroom cabinets were not equipped with child proof locks, per license, no cleaning supplies or toxic chemicals will be stored underneath bathroom cabinets, cleaning items will be kept in off limits areas. All electrical outlets in home are tamper-resistant and childproof outlets. LPA observed a sofa, changing table, and play table in bedroom #1. Changing table will be used to store children’s diapering supplies. All detergents, cleaning compounds, medications and other items which could pose a danger are stored inaccessible to children. LPA discussed installing rugs in living room to absorb and cushion falls. Cont. page 2...

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

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: GONZALEZ, KAREN	FACILITY NUMBER: 414005363
	VISIT DATE: 06/05/2026

NARRATIVE

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Then entire backyard is enclosed and surrounded by a 6 ft wood fence and a locked gate. Children will enter backyard through door in bedroom #1. Per Licensee, all outdoors toys are still at old address. Outdoor flooring is cement pavers/walkway and pebble size rocks through backyard. LPA did not observe any pools, spas or other bodies of water.

LPA observed pull down fire alarm at entrance of home. Home is equipped with a working dual carbon monoxide/smoke detector. There is a fully charged fire extinguisher 2-A:40 B:C located next to entrance door and easily accessible. LPA observed a fully stocked first aid kit and backpack. Licensee uses a designated cell phone and is aware the cell phone must stay within the home during the day care hours. Per licensee, there are no weapons or firearms in the home Licensee’s discipline techniques will be talking to children and calming techniques.

LPA reviewed the LIC311D, Records to Keep in Your Family Childcare Home, children’s forms/ records, facility forms, and information to be posted. Entrance Checklist was provided to the applicant. Licensee’s CPR/First Aid certification expires 07/2027. Licensee’s Mandated Reporter training certificate (AB1207) is current and will expire 04/2028. LPA observed emergency disaster plan (LIC610A) and facility sketches (with exit routes) posted on wall at entrance to home.

LPA and licensee discussed licensing regulations and the capacity requirements. Any children under 10 years of age that live in the home will be counted in overall capacity. LPA reminded the applicant they must be present in the home 80% of operating hours. Licensee provides meals to children in care, which will include breakfast, lunch, pm snack and dinner. LPA discussed sanitation and allergies with applicant. LPA reminded Applicant to label all food brought from home.

Licensee understands the required emergency disaster drills are to be conducted and documented at least once every six months. Applicant understands that the use of baby walkers, bouncers, jumpers, and similar items are not to be used for children in care. Smoking is prohibited inside a Family Childcare Home.

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.

Cont. page 3...

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

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: GONZALEZ, KAREN	FACILITY NUMBER: 414005363
	VISIT DATE: 06/05/2026

NARRATIVE

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The Applicant provided proof of control of property.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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 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, 5/12/2026, 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.

Licensee was reminded that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. The Applicant was encouraged to obtain a copy of regulations and current licensing forms through the Department's website at www.ccld.ca.gov. The Applicant was also reminded of Mandated Reporter Online Training for Child Care Providers (AB 1207) and the additional General Training, and both are available on www.mandatedreporteca.com.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

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: GONZALEZ, KAREN	FACILITY NUMBER: 414005363
	VISIT DATE: 06/05/2026

NARRATIVE

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Licensee 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 platform. 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.

LPA will approve relocation for large FCCH as of today June 5, 2026, prior to approval of use of backyard the following must be completed
-Submit photo of outdoor toys

Exit interview conducted and report was reviewed with Licensee, Karen Gonzalez. .

This report will be kept in the facility file and available for public review upon request. Desk duty is available Monday - Friday, 8:00 AM – 5:00 PM (650) 266-8800.
Website for Forms and Regulations: www.cdss.ca.gov.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

LIC809 (FAS) - (06/04)

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