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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005553
Report Date: 11/03/2022
Date Signed: 11/03/2022 03:40:26 PM

Document Has Been Signed on 11/03/2022 03:40 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:KUHNHAUSEN, KATIA L.FACILITY NUMBER:
214005553
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/03/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Katia KuhnhausenTIME COMPLETED:
03:55 PM
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On 11/3/2022, Licensing Program Analyst (LPA), Hanson Leong, made an announced case management visit to the Katia Kuhnhausen facility. The licensee requested a departmental visit to increase capacity from eight to fourteen children. The licensee also requested a departmental visit because she wants to use an additional room for her day-care. The LPA was granted entry by the Licensee, Katia Kuhnhausen. The LPA explained the purpose of the visit to the licensee. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. During the visit, there was no children present in the facility.

LPA and the licensee both performed a health and safety inspection of the residence. The house is clean and safe, with functioning smoke and carbon monoxide detectors as well as a fully charged fire extinguisher. The licensee has a First Aid Kit at their disposal that is filled, in addition to a thermometer. The fireplace in the house is enclosed by a child proof gate on all sides. The location of the residence does not include any bodies of water. The trash cans owned by the licensee have lids that fit tightly and are covered. Toys and equipment that are age-appropriate for the children who are being cared for at the home are always made available to them. The LPA reminded the licensee not to use baby walkers, bouncers, jumpers, or any other devices of a similar nature on the children while they were traveling in their vehicle.

LPA and the licensee carried out a thorough inspection of the additional napping room (Bedroom # 3) to look for any potential health and safety concerns. The area that is set aside for napping is well kept and clean  Every item of furniture, toy, and piece of equipment has been inspected to ensure that it is appropriate for the age range and in good shape. There are resting mats and cribs for the children to nap on while they are there, and there is also storage room for the children's own belongings. There are both smoke and carbon monoxide detectors installed in the room that is used as a napping area.
***See Page 2 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KUHNHAUSEN, KATIA L.
FACILITY NUMBER: 214005553
VISIT DATE: 11/03/2022
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The Licensee was reminded by the LPA that if she cares for the thirteenth and fourteenth children, who must be school-age, parent notification and landlord consent are required. The following is required to be posted in an accessible location in view of parents: Emergency Disaster Plan (LIC 610), Parent's Rights (LIC 995A), and License (once received).

The LPA will provide approval for Bedroom # 3 to become a component of the licensed day care facility. Bedroom # 3 will take affect on 11/3/2022.

Before the LPA approves to the change in capacity, the house must receive a fire clearance from the fire department.

Applicant was advised to contact San Bruno Regional Office for concerns or questions. Desk Duty is available Mon-Fri, 8:00am to 5:00pm at (650) 266-8800. Forms and regulations are made available at www.cdss.ca.gov/inforesources/Community-Care-Licensing.

A copy of the report and the " Notice of Site Visit," were provided to the Licensee

An exit interview was conducted, and the report was reviewed with the Licensee, Katia Kuhnhausen.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC809 (FAS) - (06/04)
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