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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001839
Report Date: 12/17/2025
Date Signed: 12/17/2025 11:14:44 AM

Document Has Been Signed on 12/17/2025 11:14 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:ALVARADO, ZENEYDAFACILITY NUMBER:
414001839
ADMINISTRATOR/
DIRECTOR:		ZENEYDA ALVARADOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 892-9036
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
12/17/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:47 AM
MET WITH:Licesnee, Zeneyda AlvaradoTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 12/17/2025, at approximately 8:45AM Licensing Program Analyst (LPA) Alvarado conducted an unannounced annual visit at the facility. LPA Alvarado met with Licensee Zeneyda Alvarado (L1) and disclosed the purpose of the visit for today which was for Plan of Correction. LPA Alvarado observed Present in the Facility is (L1) supervising 4 children (1 Infant and 3 Preschoolers). The licensee is a large license and is operating within capacity limits and ratio during today’s inspection. (L1) was reminded that if no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in 102416.5 Staffing Ratio and Capacity. Everyone in the household has fingerprint clearance and is associated to the facility during today’s inspection.

During the Annual Inspection on 9/3/2025 the facility was issued three Type B citations regarding Infant Safe Sleep and Alterations to Existing Building or Grounds. Facility was also issued three technical violations regarding physical plant and personnel records. Facility was also issued seven technical assistances regarding physical plant, infant safe sleep, personnel records and children’s records.

During today’s inspection on 12/17/2025 LPA conducted record review for children records and was able to confirm that (L1) has been documenting 15 Minute Sleep checks for infants 24 Months and under sleep checks have been properly documented and logged in a notebook. LPA advised that if notebooks will be used to document sleep checks it should be a notebook per each infant, LPA also during record review was able to confirm that (L1) provided the Individual Infant Sleeping Plan (LIC 9227) to Infant parents.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2025
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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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: ALVARADO, ZENEYDA
FACILITY NUMBER: 414001839
VISIT DATE: 12/17/2025
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LPA during record review for both Personnel Records and Children Records, also observed the Documented Emergency Drills that are properly logged last drill was conducted and documented on 9/11/2025. (L1) was reminded that Emergency drill are to be conducted and documented once every six months. LPA during record review also observed completed Personnel records for (L1) and assistant with updated Pediatric First Aid and CPR that is current Expiring 10/2027. LPA was able to see that confirm that families of enrolled children have signed Parent Rights (LIC 995) in children files.

LPA Alvarado and (L1) conducted a Health and Safety Walk through the facility indoors and outdoors. (L1) stated that the garage will no longer be in use, and LPA observed that children belonging have been moved out and is now in the main part of the home. Garage will not be part of the Family Child Care Home. Facility is still waiting on updated Fire Clearance, regarding some additional pending items that fire asked for. LPA observed a fully charged 3A40BC fire extinguisher located in the living room. LPA also observe that the fireplace that is Electric has been properly barricaded with a children’s bookshelf making it inaccessible. LPA observed a completed First Aid Kit. LPA did not observe any Babywalkers, bouncers, jumpers and similar items and (L1) was reminded that those items are not to be used for children in care and are not allowed in licensed Family child care homes.

During today’s inspection LPA was able to clear two out of the three Deficiencies that were issued on 9/3/2025. Letters of deficiencies cleared were printed and provided to (L1).

No deficiencies were cited during today's visit on 12/17/2025.

A notice of site visit was provided and must remain posted for 30 days. Appeal rights were provided and explained to (L1). Exit interview conducted and report was reviewed with Licensee, Zeneyda Alvarado.
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2025
LIC809 (FAS) - (06/04)
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