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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004603
Report Date: 03/05/2025
Date Signed: 03/05/2025 10:17:52 AM

Document Has Been Signed on 03/05/2025 10:17 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:LITTLE ROBLES IN THE SUNSETFACILITY NUMBER:
384004603
ADMINISTRATOR/
DIRECTOR:		QUINONEZ, KIMBERLYFACILITY TYPE:
850
ADDRESS:1319 20TH AVENUETELEPHONE:
(415) 508-7313
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY: 45; 45TOTAL ENROLLED CHILDREN: 45CENSUS: 42DATE:
03/05/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Kristina GonazalezTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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On March 05, 2025 at approximately 8:45am, Licensing Program Analyst (LPA) Ly conducted a Plan of Correction (POC) Visit and met with facility Owner Kristina Gonzalez and facility's Director Kimberly Quinonez. Purpose of visit was explained. Present during the visit were 14 staff including the Director caring for 42 children.


The POC is regarding Type B deficiency cited on 2/07/2025:
-Citation was cited for Staff did not have proof of completed good physical health verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure or Licensing form LIC 503.


On this day, based staff file review, LPA observed staff files have completed Licensing form LIC 503 on file. Type B deficiency cited on 02/07/2025 is cleared on this day and letter of clear deficiency provided to Facility Owner Kristina Gonzalez.

A Technical Violation was issued on 02/07/2025 regarding staff not having proof of flu vaccine or statement of declining of flu vaccine on file. Based on staff file review, all staff files have either proof of flu vaccine or statement of declining flu vaccine.

A copy of this report was discussed and left with Facility Owner whose signature on this form confirm receipt of these reports. Notice of Site Visit was provided. Notice to remain posted for 30 days. For updates 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: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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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