414004262-5-1-2023-05-CC-CQUO-CRENSL-20230501104320

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004262
Report Date: 05/01/2023
Date Signed: 05/01/2023 10:43:30 AM

Document Has Been Signed on 05/01/2023 10:43 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CATALAN, SARA INES		FACILITY NUMBER:	414004262
ADMINISTRATOR:	CATALAN, SARA INES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 754-3158
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 9	DATE:	05/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Sara Catalan		TIME COMPLETED:	11:00 AM

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 1, 2023 at approximately 8:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Sara Catalan, and explained the purpose of the inspection. Present during LPA's visit included licensee, licensee's assistant and 9 enrolled children (4 infants and 5 preschool age). Licensee is operating within capacity limits and ratio during LPA's visit. All adults working in the home have fingerprint clearance on file. Hours of operation are Monday to Friday 7:30am to 6:00pm. Licensee lives in the multi-level home. Day care entrance is through side gate, located on left side of home. Program operates on the ground level of the home only. The DAY CARE AREAS the backyard, sun room, play room (main day care area), kitchenette, and bathroom #1. The OFF LIMIT AREAS are the garage, bedroom #1 (located on ground level), and entire second level of home. LPA observed off limit areas are made inaccessible with child safety door handles. With licensee, LPA toured day care areas of home. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of toys and equipment that were in good working condition. LPA did not observe cleaning supplies, poisons or other chemicals to be accessible in day care areas. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers and/or blocked by furniture. Bathroom for children's use was observed to be clean and in proper working condition. Bathroom is equipped with appropriate toileting equipment and appropriate sanitation products. LPA did not observe any poisons, chemicals or hazardous materials in accessible drawers located in bathroom. Home is equipped with a fully charged fire extinguisher, smoke detector, carbon monoxide detector and fire alarm system. Per licensee, there are no weapons or firearms in the home. (Continue Report on Page 2...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATALAN, SARA INES	FACILITY NUMBER: 414004262
	VISIT DATE: 05/01/2023

NARRATIVE

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Entire backyard is fully enclosed with an at least 5 ft. high fence. Backyard is equipped with sufficient outdoor toys and materials that were in good working condition. LPA did not observe any spas, pools, or bodies of water on the property.

LPA reviewed five random children's files, which were complete. Children's files have a record of emergency identification information on file. Licensee's Mandated Reporter certification is current and will expire 03/2024. Licensee and licensee's assistant have record of required immunizations that were made available for review during LPA's visit. During review, Licensee did not have a current CPR certification. LPA observed licensee's CPR certification to have expired 12/2022. Per licensee, they will register for a renewed course by the end of this week.

Emergency drills are conducted monthly. Last emergency drill was conducted 04/03/2023. Licensee maintains a child care roster that was made available for LPA's review.

LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com. Licensee was reminded Mandated Reporter training must be renewed every 2 years and all staff whom directly work with children must complete training.

Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATALAN, SARA INES	FACILITY NUMBER: 414004262
	VISIT DATE: 05/01/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/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.

Licensee was issued a Type B citation for failure to maintain a current CPR/First Aid certification. Please refer to 809D for more information.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Sara Catalan.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/01/2023 10:43 AM - It Cannot Be Edited

Created By: Catrina Quimbo On 05/01/2023 at 10:11 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATALAN, SARA INES	FACILITY NUMBER: 414004262
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above by not maintaining a current CPR/First Aid certification, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/01/2023
	Plan of Correction
1 2 3 4	Licensee stated they will renew their CPR/First Aid certification by the POC due date. LPA reminded licensee certification must be EMSA certified. Licensee to provide proof of renewed (EMSA certified) CPR/First Aid certification no later than 06/01/2023 by 5:00pm.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Garfield Leung

LICENSING EVALUATOR NAME:

Catrina Quimbo

LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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