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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004728
Report Date: 07/09/2024
Date Signed: 07/09/2024 04:05:51 PM

Document Has Been Signed on 07/09/2024 04:05 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:DIAS SANTIAGO, NATANNA LUDMILAFACILITY NUMBER:
384004728
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
07/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Licensee, Natanna L. Dias SantiagoTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
NARRATIVE
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On 7/9/2024, at approximately 1:45PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced visit at the facility. LPA met with Licensee, Natanna L. Dias Santiago (L1), and explained the purpose of the visit. Present during the visit was L1, a helper (H1), and three infants. The facility is in compliance with staffing and ratio requirements on this day. The facility’s operating hours are from 8:30AM to 5:00PM.

Daycare Areas: Bedroom #1 (Play Area), Bedroom #2 (Napping Area), and Bathroom.
Off-limits Areas: Garage, Closet (located in Bedroom #2), Storage Room, Backyard, and the entire Upper Level.

LPA inspected the home for any health or safety hazards. The home is equipped with a fully charged 2A10BC fire extinguisher. There are operational carbon monoxide detectors present. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. There is no fireplace in the daycare areas. Electrical outlets are covered and inaccessible. Off-limits areas are kept inaccessible with childproof gates.

LPA observed age-appropriate toys and learning materials in Bedroom #1. Furniture is age-appropriate and free of rough or sharp edges. LPA observed there to be cribs available for each infant to nap in. The facility provides sheets and washes them twice a week. LPA discussed safe sleep regulations with L1 and H1 during the visit. LPA advised the cribs shall be free of all objects and loose articles. LPA advised that sleep sacks are not to be used for sleeping infants. L1 and H1 stated that they understood. The facility provides breakfast, lunch, and AM/PM snacks for children in care.

The Backyard is currently off-limits. LPA discussed the requirement to notify the Regional Office prior to adding a previously off-limit area to the daycare areas. L1 and H1 stated that they understood. There are no pools or other similar bodies of water present in the facility. Per L1, there are no firearms or weapons stored in the home.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: DIAS SANTIAGO, NATANNA LUDMILA
FACILITY NUMBER: 384004728
VISIT DATE: 07/09/2024
NARRATIVE
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LPA reviewed staff records, four children’s files, and facility records. L1’s First Aid/CPR is current and expires 6/2026. LPA discussed requirement to maintain staff records in the facility with L1 and H1. L1 and H1 stated that they understood. LPA observed all children’s records to be complete, including Emergency Identification and Information (LIC700), Consent for Emergency Medical Treatment (LIC627), and Notification of Parents’ Rights (LIC995A). Infant sleeping logs were available for review during the visit. All required postings were visible and accessible for review during the visit.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with Licensee 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. LPA also informed licensee 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.

LPA provided L1 with a copy of safe sleep regulations during the visit.


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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: DIAS SANTIAGO, NATANNA LUDMILA
FACILITY NUMBER: 384004728
VISIT DATE: 07/09/2024
NARRATIVE
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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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the
ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; 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.

During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited during today’s visit on 7/9/2024. See LIC9102-TV for technical violations issued today regarding logging emergency drills and the use of sleep sacks. See LIC9102-TA for technical assistance given today regarding safe sleep. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Natanna L. Dias Santiago.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
LIC809 (FAS) - (06/04)
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