<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004405
Report Date: 09/25/2024
Date Signed: 09/25/2024 04:48:18 PM

Document Has Been Signed on 09/25/2024 04:48 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:LOS LISTOS PRESCHOOLFACILITY NUMBER:
414004405
ADMINISTRATOR/
DIRECTOR:		SEGURA, ROSALVAFACILITY TYPE:
850
ADDRESS:490 MIRAMONTE AVE.TELEPHONE:
(650) 240-3233
CITY:HALF MOON BAYSTATE: CAZIP CODE:
94019
CAPACITY: 40TOTAL ENROLLED CHILDREN: 32CENSUS: 0DATE:
09/25/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Rosalva Segura and Graciela KrabbenschmidtTIME VISIT/
INSPECTION COMPLETED:
05:05 PM
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 September 25th, 2024 at approximately 1:00pm, Licensing Program Analysts (LPAs ) Alvarado and Tapia-Mandujano arrived at the facility. LPA met with Director, Rosalva Segura and Site Supervisor, Graciela Krabbenschmidt. The purpose of inspection was explained and was for an unannounced Case Management inspection for Room addition and Increase in Capacity. Per director, preschool AM program ended at 11:45am. Present in the facility are Director and Site Supervisors with some staff setting up the classrooms.

Facility is located on Hatch Elementary School. Facility is currently licensed in portable K5 and K6. Facility has requested to add portable K7 and increase capacity from 40 to 55 preschool-age children. The day and hours of operation are Monday- Friday from 8:00AM to 5:00PM, ages to serve are 2-6yrs old. LPA measured facility indoors and outdoors and inspected for health and safety hazards.

LPA measured portable K7 for a total useable indoor square footage of 915.176. Total usable sqft. divided by 35 equals to 26 preschool-age children. K7 consists of 1 toilet, 2 child size sinks. Fire clearance was received on 9/23/24.

Facility is still in the process of setting up each classroom with age-appropriate materials, equipment, and toys. Classroom must be fully set up for approval. Overall, the indoor spaces has a comfortable temperature with adequate ventilation and lighting. The classroom is equipped with storage for children's belongings. Each classroom is equipped with a Fire Extinguisher, Fire alarm system, and will install a carbon monoxide.

Facility offers an AM and PM session, children do not nap during these hours of operation. Facility has a designated space for children who feel ill or need a quiet space if needed. Per Director, facility offers breakfast, AM and PM snack provided by the school district. Per director, water services are readily available inside and outside. Children bring their own water bottles from home and also have small disposable cups available if needed. Facility has filtered water services that are available in dispensers and receives deliveries twice a month.

Continued on Page 2...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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 2
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: LOS LISTOS PRESCHOOL
FACILITY NUMBER: 414004405
VISIT DATE: 09/25/2024
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
26
27
28
29
30
31
32
Page 2 Continued...

LPAs re-measured outdoor play area. Outdoor area measures for a total useable square footage of 11,558.557; divided by 75 allows for a total of 154 preschool-age children.

The outdoor play spaces were fully enclosed with fencing and gates. Facility has age-appropriate materials and toys for preschool-age children. A large shading area is available in the play yard.

Postings still need to be posted. Required posting must be in a centralized, visible location and include the: License; Passenger Safety Laws; Notice of Parent Rights; Personal Rights; Emergency Disaster Plan; Earthquake Preparedness Checklist.

Prior for approval of Increase of Capacity and Room change, facility must submit or have the following completed:
*Classrooms must be fully set up with age-appropriate materials, objects, and equipment including making classroom free of any potential hazards.
*Required Postings must be posted in a centralized, visible area for all parents to see
*Required paperwork that is pending review
-LIC 200A
-LIC999
-Updated Bathroom Waiver
-Superintendent Letter indicating facility changes
*Lead Results posted on Waterboard Website

Based on today's inspection, deficiencies were not observed, according to California Title 22, Health and Safety Code of Regulations.

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

Exit interview conducted and report was reviewed with Director, Rosalva Segura and Site Supervisor, Graciela Krabbenschmidt.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2