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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210108889
Report Date: 06/06/2023
Date Signed: 06/06/2023 11:47:50 AM

Document Has Been Signed on 06/06/2023 11:47 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:C.A.M.(CFS)-OLD GALLINAS CHILDREN'S CENTER (SA)FACILITY NUMBER:
210108889
ADMINISTRATOR:MARIN, IRISFACILITY TYPE:
840
ADDRESS:251 NORTH SAN PEDRO ROADTELEPHONE:
(415) 479-2771
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 69TOTAL ENROLLED CHILDREN: 41CENSUS: 0DATE:
06/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Iris MarinTIME COMPLETED:
12:00 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 6/6/2023, Licensing Program Analyst (LPA) Hanson Leong, made a scheduled case management visit to the child daycare facility listed above. This facility operates a preschool and school-age program at the same location (license number 210108890). The Department has received an application from the Licensee requesting a capacity increase for the school age program. Room #6 is the one that will be added to the school age program. During today’s visit, there were no children present in the facility.

During today’s visit, the facility was checked for any health and safety concerns. Room #6 was specifically surveyed to ensure that the classroom's square footage was sufficient for the requested capacity increase. The total accessible useable space is 867 sq ft. Room #6 can accommodate roughly 24 children due to the licensing requirement of 35 sq ft indoor activity space per child. There is a centralized fire alarm, a smoke and carbon monoxide detector, and a fully charged fire extinguisher in the classroom. Toys, furniture, and equipment are offered for children. There is a storage area for children's personal items. The school age program has a total of 5 toilets, 2 urinals that can accommodate 105 children, and 6 sinks that can accommodate 90 children. There have been no alterations to the outdoor area. With the addition of classroom #6, the new school age classrooms are #6, #7 are #26 and #28.

A fire clearance inspection was conducted by the Marin County Fire Department and approved on 5/26/2023.

The LPA will approve an increase in capacity to 69 children, effective on 6/6/2023.

Today's report was reviewed and discussed with the Site Director, Iris Marin. A copy of today’s report and the “Notice of Site Visit” were given to Iris Marin. No deficiencies were cited today under the California Code of Regulations, Title 22, Division 22
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 06/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2023
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 1