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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004963
Report Date: 06/26/2024
Date Signed: 06/26/2024 12:11:08 PM

Document Has Been Signed on 06/26/2024 12:11 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:MOLINA - MANZO, GLORIA B.FACILITY NUMBER:
414004963
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
06/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Licensee, Gloria B. Molina-ManzoTIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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On June 26th, 2024, at approximately 8:40am Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced annual inspection concurrent with a case management inspection. LPA met
with licensee, Gloria B. Molina-Manzo. Upon arrival Licensee let LPA in through the front entrance of the facility. LPA disclose the purpose of the of the inspection. Present in the facility are Licensee and licensee's assistant supervising 4 children (2 infants and 2 preschoolers). At this time the licensee is within capacity limits. All adults living and working at the facility are fingerprint cleared and associated.

Licensee requested to Increase capacity to a Large License on May 15th, 2024. CCLD received fire clearance from Redwood City Fire Department on June 18th, 2024. LPA observed pull-down fire alarm is installed in the living room next to the main entrance. LPA also explained to licensee capacity limits for a large license. Licensee also requested to add the front yard as day care use. LPA inspected the front yard for health and safety hazards. LPA observed the front yard is gated, there is age-appropriate toys, and all potential hazards have been blocked off. LPA has approved the front yard for day care use.

Licensee rents one story house, which is a three bedroom one bathroom home with back and front yard, and garage. Licensee lives in the home with adult husband and two minor children. The hours of operation are Monday-Friday from 7:30m-5:00pm. New Daycare areas are: Living Room/Dining Room, Kitchen, Bathroom #1, Bedroom #1 & #3, backyard, and front yard. OFF limit areas:Bedroom #2, Garage, and Driveway. All off limit areas are properly barricaded, including closets.

LPA toured home for health and safety hazards. LPA observed the Day-care is clean, orderly with a variety of age-appropriate toys for children. The home has age-appropriate equipment available for children in care. All furniture inspected is in good repair. Home has a fireplace that is properly barricaded. Licensee does not have any pets. The home has no pools or bodies of water in the home. LPA reminded licensee of water safety hazards. Licensee was reminded that baby walkers, bouncers, jumpers and any other similar items are to not be used for children in care. LPA observed infant children sleep in cribs in Bedroom #1. LPA observed cribs to be free of loose of objects and/or articles.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
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: MOLINA - MANZO, GLORIA B.
FACILITY NUMBER: 414004963
VISIT DATE: 06/26/2024
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Licensee has a fully stocked First Aid kit and was reminded to be aware of the expiration dates. There was a fully charged fire extinguishers, smoke alarms, and carbon monoxide alarms that are in working order. Per licensee, phone number listed for Licensee is current. Per Licensee, there are no weapons or firearms in the home. Discipline policy was discussed with licensee.

LPA reviewed two children’s records which were complete. LPA also reviewed employee records which was complete. Licensees Mandated reporter training expires on 11/2024 and Pediatric CPR/First Aid certification expires on 09/2024. Last emergency drill was conducted 03/2024. Emergency drills must be conducted at least every 6 months and be properly logged. All the required posting documentation, such as the facility license, Notification of Parental Rights and have been placed in a prominent area for parents or representatives to review.

This facility provides Incident Medical Services- IMS. Licensee will submit and IMS plan to the department. LPA reminded licensee to maintain the storage of medication and equipment/supplies, and department will review children's, personnel, and administrative records when children are enrolled. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA information Line at (800) 514-0301 (voice) or (800) 514-0383 TTY) and line to publication. Commonly Asked Questions about Child Care Centers and ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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 atwww.cdss.ca.gov/inforesources/community-care-licensing/inspection-process



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

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
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: MOLINA - MANZO, GLORIA B.
FACILITY NUMBER: 414004963
VISIT DATE: 06/26/2024
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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 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.

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 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, Gloria B. Molina-Manzo, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 06/26/24.

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.

LPA will approve Large License as of today, June 26th, 2024.

Exit interview conducted and report was reviewed with licensee, Gloria B. Molina-Manzo.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC809 (FAS) - (06/04)
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