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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001659
Report Date: 09/26/2023
Date Signed: 09/26/2023 11:41:33 AM

Document Has Been Signed on 09/26/2023 11:41 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MAGANA, LETICIA ALVAREZFACILITY NUMBER:
414001659
ADMINISTRATOR:MAGANA, LETICIA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 323-2517
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY: 14TOTAL ENROLLED CHILDREN: 1CENSUS: 1DATE:
09/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee, Leticia Alvarez MaganaTIME COMPLETED:
12:00 PM
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On September 26th, 2023 at approximately 9AM, Licensing Program Analyst (LPA) Tapia-Mandujano conducted a Required Annual unannounced inspection at facility and met with licensee, Leticia Alvarez Magana. Purpose of the inspection was explained. Present in the home is licensee supervising a preschool child. Licensee is operating within capacity limits. All adults living and working in the home are fingerprint cleared and associated.

Licensee owns home 3 bedrooms, 2 bathroom, single level house. Licensee has pets, who are maintained in off limit areas and have proper documentation. The hours of operation are Monday-Friday from 6am-11pm. Daycare areas are: Living Room, Dining Room, Master bedroom (sleeping only), daycare room, Bathroom #1, and portion of backyard Off Limit areas are: Bedroom #2 and #3, Bathroom#2, Kitchen, Garage, back/side portion of backyard, and front yard. All off limit areas are properly barricaded. Due to low enrollment and renovations licensee is currently only operating in the living room, dining room, and bathroom #1.

LPA toured day care areas of home with Licensee to inspect for health and safety hazards. LPA observed home to be clean and in good repair with proper temperature and ventilation. There were a variety of age appropriate toys and equipment in the home which were in good condition. Home has a fireplace that are properly barricaded. There are no pools, and bodies of water in the premises. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Discipline Policy was discussed.

There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed for Licensee is current. Per Licensee, there are no weapons or firearms in the home. LPA reviewed the childs' record. LPA also reviewed facility records. Licensees CPR & First Aid Certificate expires on 09/2024. Licensee's mandated reporter training will expire on 09/2024. Emergency drills must be conducted at least once every six months and should be properly logged.

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

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2023
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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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: MAGANA, LETICIA ALVAREZ
FACILITY NUMBER: 414001659
VISIT DATE: 09/26/2023
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Licensee was reminded that all adults 18 and over, 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 Child Care Center. 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-and-resources/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.

Incidental Medical Services (IMS) policy was discussed. Licensee does not offer IMS at this time. 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, the licensee, Leticia Alvarez Magana, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 09/26/2023.

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

Exit interview conducted and report was translated into spanish with the licensee, Leticia Alvarez Magana.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023
LIC809 (FAS) - (06/04)
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