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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005550
Report Date: 03/07/2025
Date Signed: 03/07/2025 03:49:01 PM

Document Has Been Signed on 03/07/2025 03:49 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:C.A.M. (CFS) DE COLORES (PS)FACILITY NUMBER:
214005550
ADMINISTRATOR/
DIRECTOR:		JENNA HERZOGFACILITY TYPE:
850
ADDRESS:1123 COURT STREETTELEPHONE:
(415) 526-7500
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY: 33TOTAL ENROLLED CHILDREN: 33CENSUS: 0DATE:
03/07/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:29 PM
MET WITH:Sarah PhilipsheckTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On March 7, 2025 Licensing Program Analyst (LPA) Garcia made a scheduled case management visit to add classroom #3 and increase capacity and met with operations manager, Sarah Philipsheck. The Department received an application with Emergency Disaster Plan and sketches from the organization requesting to add day care room #3 from their existing preschool license containing rooms #1 and #2. There were no children present in the facility due to faculty in-service day.

During the inspection, the facility was inspected for health and safety hazards. Classroom #3 has a total of 544.6 sq. ft. divided by 35 sq. ft. and is sufficient for up 15 children. The classrooms has a centralized fire alarm, a smoke and carbon monoxide detector, and a fully charged fire extinguisher. The facility has age appropriate toys, furniture, and equipment available for children. There are storage spaces for children's personal belongings located inside the classroom. The outdoor space remains the same. LPA observed that there is a bathroom area with 1 toilet and total of 3 children's sinks. LPA observed that the yard consist of sand box area, small benches and play structures for outdoor activity.

The fire inspection has been completed on December 2024 to add room #3 into the preschool license. Although, another request to increase the capacity to total of 48 children will be sent to RO and another fire inspection request must be granted for that capacity before the room can be utilized.

See 809D for deficiency cited during today's visit.
Notice of Site Visit is provided and must remain posted for 30 days.

A copy of the report was reviewed and discussed with operations manager, Sarah Philipsheck.
The report will be emailed to Sarah due to printer malfunction and verification of receipt is required.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2025
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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Document Has Been Signed on 03/07/2025 03:49 PM - It Cannot Be Edited


Created By: Nathan Garcia On 03/07/2025 at 03:33 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: C.A.M. (CFS) DE COLORES (PS)
FACILITY NUMBER: 214005550

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/14/2025
Section Cited
CCR
101161(a)

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1011161 Limitations in Capacity
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidence by:
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The facility sent an application to add classroom #3 in November 2024. LPA made a case management visit to take measurements of the room during today's visit. The facility will update their application to request for a capacity increase.
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According to records review and interview, the facility is operating in classroom #3 which is not part of the preschool license. This poses a potential health and safety risk to children in care.
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The deficiency cited today will be cleared.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Daniel J Oquendo
LICENSING EVALUATOR NAME:Nathan Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2025


LIC809 (FAS) - (06/04)
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