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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004160
Report Date: 10/20/2023
Date Signed: 10/20/2023 04:45:26 PM

Document Has Been Signed on 10/20/2023 04:45 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
SAN BRUNO CHILD CARE, 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: 12CENSUS: 5DATE:
10/20/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Silivia RoldanTIME COMPLETED:
05:00 PM
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On October 20, 2023., Licensing Program Analysts (LPAs) Van and Leong met with the Licensee, Silvia Roldan, for an unannounced inspection of the Plan of Correction (POC). The purpose of the inspection was explained, and the Licensee granted LPAs entry to the home. There were 5 children in care with the Licensee today (3 infants and 2 preschoolers).

During the October 11, 2023, annual inspection, the Licensee was cited for several deficiencies. Two of the cited deficiencies were related to the Licensee's failure to comply with the infant safe sleep regulation. Specifically, the Licensee did not maintain an infant sleeping log and also failed to provide parents of infants under 12 months of age with the Individual Infant Sleeping Plan (LIC 9227). Additionally, a type A citation was also issued during the inspection as the Licensee provided care for 7 infants, which exceeded the maximum license capacity and limitation of 4 infants.

In today's inspection, the records for all infants were reviewed. The records confirmed that all infants under 12 months old had an Individual Infant Sleeping Plan on file. The licensee also kept records of the infants' sleeping logs, and 15-minute intervals were documented. During the inspection, the LPAs observed three infants and two preschoolers. In addition, a new updated children roster was reviewed and showed Licensee has four infants and two preschoolers enrolled. The licensee adhered to her licensed capacity and limitations today. All the deficiencies cited on October 20, 2023, were cleared today.

An exit interview was conducted with the Licensee, and a consultation was provided. In today's inspection, no deficiencies were observed. The Licensee, Silvia Roldan, read and signed the report. Today's report and notice of the site were provided to the Licensee. LPA informed the Licensee that a site visit notification must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
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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