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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005606
Report Date: 07/27/2023
Date Signed: 07/27/2023 11:42:53 AM

Document Has Been Signed on 07/27/2023 11:42 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:GONZALEZ, ELIZABETHFACILITY NUMBER:
214005606
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
07/27/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:22 AM
MET WITH:Elizabeth GonzalezTIME COMPLETED:
12:00 PM
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On July 27, 2023, at approximately 10:10 am, Licensing Program Analyst (LPA) Nathan Garcia conducted an unannounced inspection for increase of capacity today and met with licensee, Elizabeth Gonzalez for her request to increase from a Small to a Large Family Child Care. Fire Clearance was received by Novato Fire Department on 7/18/23. Fire Department excluded the use of the second floor. Present in the home are licensee, and husband caring for 4 children. Two of the children present are the Licensee's children. All adults living and working in the home have fingerprint clearance and are associated to the facility.

Licensee owns the home, which is a 4 bedroom and 3 bathroom house with a backyard. Licensee lives in home with adult husband and two minor children. The hours of operation are Monday-Friday from 8am-5pm. LPA and licensee inspected day care areas for health and safety hazards.

Day-care areas are: Downstairs Bedroom #1, Living Room, Dining Room, Bathroom #1, kitchen and back/side yard.
Off limit areas are: Bedroom #2 & #3, and #4, upstairs. All off limit areas, including all closets, are properly barricaded.

LPA observed home to be clean and in good repair with proper temperature and ventilation. There is a variety of age appropriate toys and equipment in the home which are in good condition. There are no pools, spas, or bodies of water on the property. Home has a fireplace that is properly barricaded/sealed off. Backyard is fenced and properly barricaded. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children. There is a fully charged fire extinguisher, and a working telephone. Per Licensee, there are no weapons or firearms in the home. Licensee has no pets in the home. Licensee's CPR & First Aid expires on 07/15/2025. Licensee's Mandated Reporter certificate expires on 02/2024. Postings were posted near main door. Licensee is reminded of NO walkers, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. Capacity limits of a Small and Large Family Child Care Home were explained.

LPA will reccommend for approval of a Large Family Child Care Home License as of today, July 27th, 2023.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed by licensee, Elizabeth Gonzalez.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
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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