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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214005660
Report Date: 10/18/2024
Date Signed: 10/18/2024 10:53:06 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/10/2024 and conducted by Evaluator Hanson Leong
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20241010154819
FACILITY NAME:REYES VASQUEZ, ELMA E.FACILITY NUMBER:
214005660
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 2DATE:
10/18/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Elma Reyes VasquezTIME COMPLETED:
11:05 AM
ALLEGATION(S):
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Facility operated over capacity
INVESTIGATION FINDINGS:
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On 10/18/2024, Licensing Program Analysts (LPAs) Leong and Gil conducted an unannounced complaint visit and met with the Licensee, Elma Reyes Vasquez. LPAs explained the purpose of the visit to the licensee.

Two infants and three adults (the licensee, the licensee’s husband, and the licensee’s assistant) were present during today’s visit. The three adults received criminal record clearance from the department.

All relevant information was gathered and analyzed during the LPA investigation, and all parties involved were contacted and interviewed. Based on the information obtained during the investigation and record review, LPA concluded that the licensee exceeded the license capacity for at least one day in August and September 2024. Therefore, the preponderance of evidence has been met, and the above allegation is found to be substantiated.

See Page 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 05-CC-20241010154819
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 10/18/2024
NARRATIVE
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Page 2

LPAs informed the licensee to provide a copy of this licensing report dated 10/18/2024 that documents any Type A citations to the parents or guardians of all children currently enrolled by the next business day or the next day the children are in care and to the parents or guardians of any newly enrolled children for a period of 12 months from the date of this report. The deadline for providing this information is the next business day, 10/21/2024. For the purposes of verification, the child's file needs to have either a signed Acknowledgement of Receipt of Licensing Report (LIC 9224) or another type of written statement.

Please refer to LIC 809D for today’s violation.

The facility’s appeal rights were given to the Licensee, Elma Reyes Vasquez.

LIC 809D (citation page) and A Notice of Site Visit were given, and both must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Elma Reyes Vasquez.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20241010154819
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/21/2024
Section Cited
CCR
102416.5(a)
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(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time

This requirement is not met as evidenced by:
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The licensee must comply with the maximum number of children allowed for the facility's license. An updated children's roster (LIC 9040), and children's schedule must be submitted to the department.
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Based on record review, the licensee did not comply with the section cited above for one day in August and September 2024, which poses an immediate health, safety, or personal rights risk to children in care.
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Authorized Representatives must sign the LIC9224, Notice of A type deficiency. A follow-up visit will be required to ensure that the license is in accordance with the section cited above.
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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.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3