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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004160
Report Date: 09/14/2022
Date Signed: 09/14/2022 03:59:36 PM

Document Has Been Signed on 09/14/2022 03:59 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:ROLDAN, SILVIA E.FACILITY NUMBER:
384004160
ADMINISTRATOR:ROLDAN, SILVIA E.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 879-2418
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 12TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
09/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Silvia Roldan TIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Silvia Roldan, and her helper. All adults had fingerprint clearance. The purpose of the inspection was explained to her. The licensee rented this 2 stories single family house. There were 6 children that included 2 infants with a helper present. The children were napping upon LPA's arrival. The licensee lived in the house by herself. The house had 2 bedrooms, a living room, dining room, bedroom #1& #2 (Licensee's bedroom that across the bathroom), backyard, and a garage. The daycare areas were living room, dining room, bedroom #1, bathroom, and backyard. The kitchen area was used as a pathway to the backyard only. The off-limit areas were bedroom #2, and a garage. LPA toured the facility for health and safety hazard. The house was clean and in order. The temperature and lighting were adequate. All toxins and harmful objects were made inaccessible to the children. There were plenty of age-appropriate toys, books, learning material, and children's furniture that were in good condition and repaired available for children. All windows in the living and dining rooms were barricaded to prevent children fall out from the windows. All electrical outlets were covered. There were a fully charged 2A10BC fire extinguisher, and first aid supplies available in the daycare. LPA did not test the carbon monoxide and smoke detectors due to napping during the inspection. There was a gate available at the kitchen entrance from the dining room to avoid children's access. The bedroom #1 is next to the dining room for napping. Play pens and mats were available for napping, The licensee provides breakfast, lunch and AM/PM snacks to the children. The children's bathroom was clean and no harmful objects were observed. The outdoor play was fenced. The backyard was clean and no harmful objects. There were planty of age-appropriate toys, tide on toys, slide structure, and children's furniture available for the daycare children. The licensee installed the fake grass to the ground as soft cushioning. The licensee had no guns, weapons, and pets in the house. All the required postings were posted in the daycare areas. LPA also obtained a copy of the current children roster from the licensee during the inspection. LPA reviewed the children's file. The licensee and her helper had current CPR/First Aid training, they will expire in 7/2024. The licensee and her helper also had the current Mandated Reporter Training (AB1207), they will expire in 9/2023. The facility has conducted the emergency drill 2 times a year and logged. The licensee had the hand sanitizer, and touchless thermometer available by the main doorway.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2022
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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