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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004308
Report Date: 01/22/2024
Date Signed: 01/22/2024 11:32:03 AM

Document Has Been Signed on 01/22/2024 11:32 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:GUTIERREZ, VERONICAFACILITY NUMBER:
414004308
ADMINISTRATOR:GUTIERREZ, VERONICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 679-4113
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
01/22/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Licensee, Veronica GutierrezTIME COMPLETED:
11:50 AM
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On January 22nd, 2024, at approximately 8:45am, Licensing Program Analyst (LPA) Tapia-Mandujano arrived at the facility to conduct a Case Management-Licensee initiated and an annual inspection. LPA was granted entrance by Licensee. LPA explained the purpose of the inspection. LPA met with licensee, Veronica Gutierrez.Licensee has requested to add her front yard for child care area as her backyard will be getting renovated.

Present in the facility were licensee and assistant supervising and caring for 10 children (4 infants and 6 preschool age). Facility is operating within capacity limits on this day. All adult living and working in the home are fingerprint cleared and associated.

Licensee owns home, which is a 2 bedroom, 1 bathroom, single story house. Licensee lives with Husband and 2 minor children. Licensee has pets, who are current on their immunization. The hours of operation are Monday-Friday from 7:30am-5:30pm. Daycare areas are: Living Room, Dining area, Bathroom #1, Bedroom #1, and Backyard. Off Limit areas are: Bedroom #2, Kitchen, Laundry Room, Deck (pass through only), Garage, Front yard, and Side yards. Off limit areas, including closets, are properly barricaded.

LPA inspected the front yard area for health and safety hazards. Front yard is fenced with and is free of hazards. Front yard does have a fountain that is approximately 2 feet off the ground in the corner of the house. LPA explained water safety precautions with licensee and ensuring that children are safe and observed in that area. Licensee states that she understands. LPA has approved the front yard for child care use.

NEW DAYCARE AREAS: Living Room, Dining area, Bathroom #1, Bedroom #1, Front Yard and Backyard.



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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2024
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: GUTIERREZ, VERONICA
FACILITY NUMBER: 414004308
VISIT DATE: 01/22/2024
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LPA toured the rest of the 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 is properly barricaded. There is now a fountain in the front yard that is about 2 feet from the ground. There are no pools in the premises. Per licensee, she will occasionally have water play and will dump all the water out after every use.

All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Discipline Policy was discussed. Infant children sleep in a pack and play in Bedroom #1. LPA observed that the door to the room was open and the pack and plays are not blocking any entrances or exits. LPA notified licensee that sleep sacks are no longer allowed.

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 five children's' record which were complete. LPA also reviewed facility and assistant records. Licensees CPR & First Aid Certificate will expire 01/2025. Licensee's Mandated Reporter Training will expire on 01/2026. Last Emergency drill was conducted 01/2024. 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

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.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024
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: GUTIERREZ, VERONICA
FACILITY NUMBER: 414004308
VISIT DATE: 01/22/2024
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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. 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 moment. 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, Veronica Gutierrez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 01/22/2024..

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

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

Exit interview conducted and report was reviewed with licensee, Veronica Gutierrez.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024
LIC809 (FAS) - (06/04)
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