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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005660
Report Date: 10/20/2023
Date Signed: 10/20/2023 11:49:48 AM

Document Has Been Signed on 10/20/2023 11:49 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:REYES VASQUEZ, ELMA E.FACILITY NUMBER:
214005660
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
10/20/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Elma Reyes VasquezTIME COMPLETED:
12:00 PM
NARRATIVE
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On 10/20/2023, Licensing Program Analysts (LPAs) Leong and Van, conducted a scheduled, pre-licensing inspection with the Applicant, Reyes Vasquez. Ms. Reyes Vasquez requested a visit from the department because she applied for a Small Family Child Care Home license. The LPAs were granted entry by Ms. Reyes Vasquez. The LPAs explained the purpose of the visit to Ms. Reyes Vasquez. During today’s visit, the licensee’s husband and daughter were present in the home. The LPAs also observed that was a dog present in the home. During today's visit, Ms. Reyes Vasquez presented a copy of the dog's rabies shot to the LPAs.

Ms. Reyes Vasquez rents the home. Ms. Reyes Vasquez intends to open from 7:30 am to 5:30 pm, Monday through Friday. Before children enroll, Ms. Reyes Vasquez states that she will consider purchasing liability insurance for her home day care. The LPAs informed Ms. Reyes Vasquez that if she does not purchase insurance for her childcare, she must notify the parents using the LIC 282 form. Ms. Reyes Vasquez plans to care for children ranging in age from three months to three years old. Ms. Reyes Vasquez intends to provide food for the children in her care.

Ms. Reyes Vasquez has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, Ms. Reyes Vasquez understands that, once licensed, they can operate with a maximum capacity of 6 children. ***See Page 2***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: REYES VASQUEZ, ELMA E.
FACILITY NUMBER: 214005660
VISIT DATE: 10/20/2023
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Parental notification is required if Ms. Reyes Vasquez provides care for a seventh and eighth child who is of school age. Emergency Disaster Plan (LIC 610), Parent's Rights (LIC 995A), and License (once received) are required to be posted in an accessible location where parents can see them.

Daycare areas: Activities Room, Dining Area, Kitchen (walk through only), Bedroom # 4 (napping room), Bathroom, and Backyard.

Off-limits areas: Bedroom #1, Bedroom # 2, Bedroom #3, Garage and Living room.

The LPAs and Ms. Reyes Vasquez both conducted a health and safety inspection of the home. The home is clean and safe, with a working smoke detector, a carbon monoxide detector, and a fire extinguisher. Ms. Reyes Vasquez has a first aid kit that is fully stocked with all the necessary supplies for treating injuries. The LPAs found that the facility did not have any pools, spas, or other types of bodies of water of any kind. Ms. Reyes Vasquez has garbage cans with tightly fitting covered lids. The children in care have access to age-appropriate toys and equipment. The LPAs reminded Ms. Reyes Vasquez that baby walkers, bouncers, jumpers, and other similar equipment should not be used on children who are in care. The LPAs observed napping playpens and cots were present in the home. Ms. Reyes Vasquez has a designated cell phone and is aware that it must be kept in the home during day care hours. According to Ms. Reyes Vasquez, there are no firearms or weapons in the unit. According to Ms. Reyes Vasquez, the front of the home will be the isolation area for a sick child. All hazardous materials and toxins are kept out of children's reach and are inaccessible. ***See Page 3***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: REYES VASQUEZ, ELMA E.
FACILITY NUMBER: 214005660
VISIT DATE: 10/20/2023
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The LPAs reminded Ms. Reyes Vasquez that the CPR and First Aid training must be renewed every two years. Ms. Reyes Vasquez has proof that she has received the MMR and TDAP vaccinations. Ms. Reyes Vasquez has completed the Mandated Reporter Training. The LPAs reminded Ms. Reyes Vasquez that the Mandated Reporter Training must be renewed every two years. The LPAs informed Ms. Reyes Vasquez that emergency disaster drills should be conducted at least once every six months and that the date and time of the drill should be recorded.

LPAs discussed the safe sleep regulations with Ms. Reyes Vasquez and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPAs also informed Ms. Reyes Vasquez 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.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, 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. ***See Page 4***
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: REYES VASQUEZ, ELMA E.
FACILITY NUMBER: 214005660
VISIT DATE: 10/20/2023
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LPAs reviewed with Reyes Vasquez the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to Ms. Reyes Vasquez.

Ms. Reyes Vasquez 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.

Ms. Reyes Vasquez was informed 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 LPAs reviewed AB 1207 with Ms. Reyes Vasquez.

Ms. Reyes Vasquez was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care 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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication. ***See Page 5***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: REYES VASQUEZ, ELMA E.
FACILITY NUMBER: 214005660
VISIT DATE: 10/20/2023
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Ms. Reyes Vasquez 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.

The LPAs will not recommend Ms. Reyes Vasquez for Small Family Child Care license until Ms. Reyes Vasquez’s husband obtains fingerprint clearance.

A copy of today's report was given to Elma Reyes Vasquez. An exit interview was conducted, and the report was reviewed with Elma Reyes Vasquez.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023
LIC809 (FAS) - (06/04)
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