384005214-5-12-2026-05-CC-CQUO-DTZR6M-20260512124459

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384005214
Report Date: 05/12/2026
Date Signed: 05/12/2026 12:45:19 PM

Document Has Been Signed on 05/12/2026 12:45 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	RESENDIZ, ARIANA		FACILITY NUMBER:	384005214
ADMINISTRATOR/ DIRECTOR:	ARIANA RESENDIZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 646-5561
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/12/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Ariana Resendiz		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On May 12, 2026 at approximately 9:00am, Licensing Program Analyst (LPA) Quimbo conducted a scheduled, pre-licensing visit. LPA met with applicant, Ariana Resendiz, and explained the purpose of the visit. No other adults or individuals were present during LPA's visit. Applicant submitted a family childcare home application April 28, 2026. Applicant also requested for a large capacity. Fire clearance for the home was received May 11, 2026. Applicant has fingerprint clearance on file and is associated to facility number. Applicant plans to operate Monday through Friday 8:30am to 5:00pm. Per applicant, extended hours may also occur. Applicant plans to care for children ages 1 year to 5 years old. LPA inspected the entire home for health and safety hazards. The home is a multi-level home that consists of 3 bedrooms, 2.5 bathrooms, living room, dining area, kitchen, terrace, backyard and garage. The DAY CARE AREAS are the living room, dining area, kitchen, bedroom #1 (napping room), bedroom #2 (art room), bathroom #1, terrace, and backyard. The OFF LIMIT AREAS are bathroom #2, bedroom #3, garage and bathroom in garage. There are stairs that lead to the garage that includes a closed door. Applicant will install a child safety door handle to door that leads to garage. Access to off limit bathroom is made inaccessible with child safety locks. There is also a child safety gate in the hallway that makes bedroom #3 inaccessible through the hallway. LPA observed a connecting door from bedroom #1 that can lead to the hallway to bedroom #3. Applicant plans to install a child safety door handle to bedroom #1's exit door handle to ensure access to off limit bedroom is made inaccessible to children. Applicant was notified any off limit areas are not to be used as a day care area without prior approval from the department. (Continue report on page 2...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: RESENDIZ, ARIANA	FACILITY NUMBER: 384005214
	VISIT DATE: 05/12/2026

NARRATIVE

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LPA observed the day care areas to be clean. Home is equipped with a variety of children's toys and materials that are in good condition. LPA observed toys and materials to include materials for dramatic play, block building, puzzles, and a cozy area. Per applicant, toys and materials will be sanitized weekly or as needed.

Living room includes a fireplace that was boarded and made inaccessible to children. Flooring in living room and dining area includes hard wood floor that is also in good condition. There is a rug in the living room. Per applicant, rug will be vacuumed daily while remainder of floor will be swept and mopped daily.

Applicant plans for children to play in the living room and art room, eat in the dining area and/or terrace, and sleep in the napping room. Per applicant, children will also occasionally cook in the kitchen. There is a large window in the art room. LPA observed lower portion of the window to be boarded for children's safety. LPA advised applicant to install a window stopper to window for additional safety. LPA observed electrical outlets in home to be made inaccessible with child safety covers.

Children will sleep in the napping room on floor yoga mats. Sheets and blankets will be provided by children's families and sent home weekly for laundering. Per applicant, mats are sanitized weekly. LPA reminded applicant's children's personal belongings are to be labeled with children's individual names.

Bathroom for children's use was observed to be in working condition. LPA felt hot water temperature from sink and advised for hot water to be turned down. Applicant stated hot water is not used for children nor are children in the bathroom alone. There is age appropriate toileting equipment for children who will be potty training. There is a diaper changing pad in the home, when needed. Applicant plans to provide diapers and wipes for diapering children. Applicant plans to dispose of dirty diapers daily, outside of the home.

Home is equipped with a fully charged fire extinguisher, fire alarm, first aid kits, and smoke and carbon monoxide detectors. LPA tested a combination smoke and carbon monoxide detector during today's visit which was observed to be in working condition.

Applicant plans to provide a food service for children that includes lunch and snacks. Food preparation, sanitization, children's allergies was discussed. Applicant plans to utilize reusable utensils and plates for children that will be washed daily in home's dishwasher or hand washed. LPA observed knives in kitchen to be stored on a high shelf, inaccessible to children. LPA also observed poisons and cleaning solutions to be stored behind a child safety locked cabinet in kitchen. There are also child safety handles on stove's knobs. Applicant plans to install additional child safety locks on cabinets and drawers in kitchen.
(Continue report on page 3...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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: RESENDIZ, ARIANA	FACILITY NUMBER: 384005214
	VISIT DATE: 05/12/2026

NARRATIVE

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Access to the backyard is through the terrace. LPA observed terrace to be fully enclosed and fenced. There are stairs from the terrace that lead to the backyard. LPA observed a child safety gate at both the bottom and top of the stairs. Backyard is also fully fenced and enclosed. Backyard includes a variety of outdoor toys and materials. There is a play structure that includes swings and a slide. Flooring in backyard includes resilient padding of both sand and hay. Per applicant, outdoor toys and materials are sanitized at least once every two weeks or as needed. LPA did not observe any pools, spas or bodies of water on site.

Applicant was reminded baby walkers, bouncers, jumpers and any other similar items are not to be used for children in care. LPA reminded applicant emergency disaster drills are to be conducted and documented at least once every six months.

Applicant's discipline policy will be communication and a quiet break. The designated isolation area will be the napping room, separate from other children in care. LPA reminded applicant, children must be supervised at all times.

Applicant's Pediatric CPR/First Aid training is current and will expire February 2028. Applicant's Mandated Reporter training certification has expired as of March 2026. Applicant is currently in the process of renewing certificate. LPA reminded applicant CPR/First Aid training and Mandated Reporter training must be renewed every two years. Applicant was also reminded Mandated Reporter training must be renewed every two years by all staff working with children. Applicant has proof of required immunizations that were provided to department. LPA observed licensing documents to be posted in home. Per applicant, there are no weapons or firearms in the home. Per applicant, there are no pets in the home.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

The applicant has provided proof of control of property. The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC 9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 12 children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 14 children.
(Continue Report on Page 3...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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: RESENDIZ, ARIANA	FACILITY NUMBER: 384005214
	VISIT DATE: 05/12/2026

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant 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 applicant of the importance of checking for and removing 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.

On this date, 05/12/2026, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters, and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/communitycare-licensing/subscribe and select the Child Care option to receive email communication.
(Continue report on page 5....)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: RESENDIZ, ARIANA	FACILITY NUMBER: 384005214
	VISIT DATE: 05/12/2026

NARRATIVE

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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.

Applicant was reminded they must live in the family child care home to be licensed. Applicant was reminded that they are the primary caretaker for the family child care home to be licensed. Applicant was also reminded that they are responsible and liable for everything that occurs with the licensed family child care home to be licensed.

Due to not obtaining landlord consent, maximum capacity applicant can be licensed for will be 12 children. LPA discussed capacity requirements with applicant. Applicant was reminded that an assistant must be present when working with a capacity of a large license. LPA informed applicant that if applicant is working alone, applicant must work within capacity limits of a small license.

During today's visit, LPA received most current version of Application for a Family Child Home License (LIC279) and applicant's most current influenza vaccine.

Prior to recommended licensure, following must be completed:
-Installation of sound alarm on exit door in backyard.
-Securing of play structure in backyard.
-Installation of child safety locks on kitchen's cabinets, drawers and oven.
-Installation of a child lock on window in art room.
-Covering of electrical outlet in art room.
-Installation of a child safety door handle on exit door in napping room (that can lead to off limit bedroom).
-Installation of a child safety door handle to garage door.
-Posting of Earthquake Preparedness Checklist (LIC9148).
-Submission and approval of control of property with applicant's name.
-Applicant's renewed Mandated Reporter certification (AB1207).
-Management approval

Exit interview conducted and report was reviewed with the applicant, Ariana Resendiz.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC809 (FAS) - (06/04)

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