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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000782
Report Date: 01/24/2024
Date Signed: 01/24/2024 01:22:30 PM

Document Has Been Signed on 01/24/2024 01:22 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:GARCIA, MARIA MATILDEFACILITY NUMBER:
414000782
ADMINISTRATOR:GARCIA, MARIA MATILDEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 366-0732
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 3DATE:
01/24/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Maria Matilde GarciaTIME COMPLETED:
01:35 PM
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On January 24, 2024 @ approx.11:45AM, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Maria Garica for an unannounced annual inspection. The purpose of the inspection was explained. Present today was Licensee, spouse and 3 children (1 infant and 2 preschoolers). All adults present at facility have fingerprint clearance. Licensee is operating within capacity and ratio requirements on this day. Hours of operation are Monday– Friday, 7:30 am - 5:30pm.

LPA and Licensee toured the home for health and safety hazards. Home is a one-story home. Entrance to daycare is located behind home. Day Care Areas: living room, kitchen, the bathroom, garage, and the backyard. Off Limit Areas: all bedrooms. Off limits areas are properly barricaded with closed door during daycare hours and child proof gates. Home is well light and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to children behind childproof cabinets. All cabineats are equipped with child safety locks. All electrical outlets are secured with child proof covers. There is a portable A/C heater unit located in garage, which is properly secured. There are plenty of age-appropriate toys, books, child size furnishings, learning material, wall mounted changing table, playpens and sleeping mats. Parents provide sheets for playpens and are sent home weekly for laundering. Outdoor play area is gated and located outside garage door/daycare entrance. Outdoor play area has plenty of age-appropriate toys, ride on toys and is equipped with concrete. Per licensee, they walk to the park across the street to play. Park is equipped with a playground structure. Outdoor area is surrounded with a 4 ft. fence. There are not spas, pools, or other bodies of water.

Home is equipped with a working dual carbon monoxide/smoke detector. LPA observed a fully charged fire extinguisher. Fire alarm is located in garage. Isolation area for ill children will be in living room and away from other children. LPA reviewed first aid kit and kit is fully stocked. Licensee has a landline in home and uses cell phone on the premises. Per licensee, there are no weapons or firearms in the home.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2024
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 3
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: GARCIA, MARIA MATILDE
FACILITY NUMBER: 414000782
VISIT DATE: 01/24/2024
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LPA reviewed 3 children’s records. All records are complete and up to date. Children’s file included LIC282 Affidavit. Licensee maintains an updated Children’s roster. Licensees CPR/FA expires 02/2025. Licensee Mandated Reporter training expires 07/2024. Licensee provides breakfast, lunch, and afternoon snack to children in care. LPA reminded Licensee to label children's food/bottles brought from home. LPA observed Childcare License and Parent's rights posted. Last emergency drill was conducted on 12/22/2023 and is properly documented. LPA reviewed sleep logs for children under the age of 2 yrs. old.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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 are available at: https://www.ada.gov/resources/child-care-centers/.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA's reviewed AB 1207 with the Licensee.

As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com


Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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: GARCIA, MARIA MATILDE
FACILITY NUMBER: 414000782
VISIT DATE: 01/24/2024
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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-and-resources/safe-sleep as an additional resource. LPAs also informed licensees 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 discussed sleep sacks and sleeping logs.

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 informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.

A notice of site visit was given to licensee and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Maria Garcia. LPA translated report in Spanish to Licensee.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC809 (FAS) - (06/04)
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