414004675-6-5-2024-05-CC-HLEG-D5XPLK-20240605112452

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004675
Report Date: 06/05/2024
Date Signed: 06/05/2024 11:25:02 AM

Document Has Been Signed on 06/05/2024 11:25 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:	GOOMER, SEEMA		FACILITY NUMBER:	414004675
ADMINISTRATOR/ DIRECTOR:	GOOMER, SEEMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 627-7206
CITY:	MILLBRAE	STATE: CA	ZIP CODE:	94030
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 9	CENSUS: 9	DATE:	06/05/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:35 AM
MET WITH:	Seema Goomer		TIME VISIT/ INSPECTION COMPLETED:	11:38 AM

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On 6/5/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit to the Family Childcare Home (FCCH) listed above. LPA met with the Licensee, Seema Goomer, and explained the purpose of the visit. Eight preschool-aged children, one infant, the licensee, and the licensee's three assistants were present during the visit. The licensee and the licensee’s three assistants present at the FCCH received criminal record clearance from the department. The FCCH operates within its capacity and in accordance with the required ratio of staff to children.

LPA observed that all required documents were displayed, such as the facility license, the Notification of Parental Rights, and the Earthquake Preparedness Checklist.

LPA observed that the last emergency disaster drill was conducted on 5/6/2024 and properly recorded.

According to the licensee, the FCCH provides food and snacks for the children. LPA reminded the licensee about the importance of sanitation and proper food preparation.

Daycare Areas: Lower level only: Veranda,' portion of backyard/Grass area, Daycare Room, Nap room, and Bathroom #1.

Off-limit areas: Lower level: The pool area in the backyard, garage, and side yard; the entire upper level of the home. The licensee understands that off-limits areas may not be used for childcare during business hours.

LPA conducted an inspection for potential health and safety hazards and found the home's interior to be clean, safe, and well-maintained. The FCCH was observed to have a first aid kit, functioning smoke and carbon monoxide detectors, and a fully charged fire extinguisher.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

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

FACILITY NAME: GOOMER, SEEMA	FACILITY NUMBER: 414004675
	VISIT DATE: 06/05/2024

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LPA observed that the indoor daycare areas were equipped with age-appropriate toys, furniture, and educational materials. No equipment, such as walkers, bouncers, or similar objects, was present in the FCCH. Feeding chairs were observed to be available for children to use. A safety gate was observed to be installed at the stairs.

Poisons, cleaning solutions, and chemicals were observed in the garage and are inaccessible to the children.

The outdoor playground was enclosed by a fence, and the equipment was well-maintained. The areas around and under high climbing equipment, swings, slides, and similar equipment were cushioned with material that absorbs falls. The swimming pool is surrounded by a fence, and the pool cover was observed to be properly secured.

The bathroom was found to be clean and fully functional. The toilet and handwashing facility were kept safe and sanitary.

According to the licensee, no firearms or weapons are on the premises.

The FCCH has a designated sleeping/resting area for children and a clean diaper-changing station stocked with wipes and diapers. Cots, playpens, sheets, and blankets were observed to be present in the home. LPA also observed that the infant mattresses were firm and appropriately covered with a fitted sheet appropriate to the child’s size.

LPA reviewed five children’s files and confirmed that all five children have complete files that include their emergency contact and medical information. LPA reminded the licensee that sleep logs indicating a staff checking on a child every fifteen minutes must be used for children under two years old.

LPA reviewed four staff files and confirmed that all required forms were present. LPA found that the licensee possesses a current Pediatric First Aid/CPR certification expiring on 3/2026. LPA reminded the licensee that Mandated Reporter training must be completed every two years, and immunization records must be placed in the staff files.
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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

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

FACILITY NAME: GOOMER, SEEMA	FACILITY NUMBER: 414004675
	VISIT DATE: 06/05/2024

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Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Incidental Medical Services (IMS) policy was discussed. 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/.

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-andresources/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 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 confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

On this date, 6/5/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

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

FACILITY NAME: GOOMER, SEEMA	FACILITY NUMBER: 414004675
	VISIT DATE: 06/05/2024

NARRATIVE

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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.

No deficiencies were issued today during LPA's visit.

A copy of today's report was given to the Licensee, Seema Goomer. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Seema Goomer.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

LIC809 (FAS) - (06/04)

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