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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004818
Report Date: 06/07/2023
Date Signed: 06/07/2023 02:04:14 PM

Document Has Been Signed on 06/07/2023 02:04 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CARBALLO RAMOS, AIDA VIRGINIAFACILITY NUMBER:
414004818
ADMINISTRATOR:CARBALLO RAMOS, AIDA V.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 798-4825
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
06/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:58 AM
MET WITH:Aida Virginia Carballo RamosTIME COMPLETED:
02:25 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 June 7, 2023, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced annual inspection in conjunction with delivering the complaint findings. LPA met with Aida Virginia Carballo Ramos and purpose of visit was explained. Present today is Licensee, three helpers and 8 children (3 infants & 5 preschool children). Licensee is operating within capacity and ratio requirements on this day. Licensee and helpers have criminal record clearances on file with the department. Hours of operation are Monday– Thursday, 7:30am to 5:30pm & Friday 7:30 – 4:00pm.

LPA and Licensee toured the home for health and safety hazards. The home is a two-story level home. Day Care Areas: Entire downstairs, which includes a bathroom and one bedroom on 2nd floor is used for napping purpose only.. Off Limits Areas: Upstairs and garage. Staircase is properly barricaded with child proof gate. The home is clean and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. There are plenty of age-appropriate toys, child size furnishings, learning material and sleeping cribs. Licensee and Parents both provide sheets and are sent home for weekly washing. Outdoor play area has a swing set, small play structure, riding toy and easels all in good condition. Backyard is completely fenced and has artificial grass to cushion falls. There are no pools, spas, or other bodies of water on the property. Licensee provides and cooks meals for children in care. LPA observed food to be properly stored to avoid contamination.

The home is equipped with a dual carbon monoxide/smoke detector and a fully charged fire extinguisher. Isolation area for ill children outside with supervision. First aid kit is fully stocked with supplies. Licensee uses a cell phone and understands cell phone is to stay in home during daycare hours. Per licensee there are no weapons or firearms in the home.

Cont. page 2...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2023
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 5
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: CARBALLO RAMOS, AIDA VIRGINIA
FACILITY NUMBER: 414004818
VISIT DATE: 06/07/2023
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...

LPA reviewed 5 children’s records and all required documents were in children’s files. Helper files are complete with CPR/First Aid, Mandated Reporter, Immunization's records, and all other required documents. Licensee CPR/First Aid is current and will expire on 01/2025. Mandated Reporting will expire 06/2023. Children’s roster was reviewed and is up to date. Last emergency drill was documented on 3/07/2023. Licensee has liability insurance through Markel Insurance.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Where 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 and Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

Cont. page 2...

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: CARBALLO RAMOS, AIDA VIRGINIA
FACILITY NUMBER: 414004818
VISIT DATE: 06/07/2023
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 3...

Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee.

Safe Sleep
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. Safe Sleep Sacks were discussed, Licensee will request waiver. Sleeping logs regulation was discussed with Licensee and technical violation issued for sleeping logs. LPA reminded Licensee to remain on same level of sleeping children, LPA issued a technical violation.

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.


A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
.
Exit interview conducted and report was reviewed with the licensee, Aida Virginia Carballo Ramos.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5