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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004987
Report Date: 04/14/2025
Date Signed: 04/14/2025 04:24:09 PM

Document Has Been Signed on 04/14/2025 04:24 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:PADILLA, MARISOLFACILITY NUMBER:
414004987
ADMINISTRATOR/
DIRECTOR:		PADILLA, MARISOLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 440-7915
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
04/14/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:34 AM
MET WITH:Emilsa LimaTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 04/14/25 at approximately 8:45am Licensing Program Analyst (LPA) Katie Krenn made an unannounced annual visit. LPA met with Emilsa Lima, who said that the licensee, Marisol Padilla was taking the day off. Present at the facility when LPA arrived, were three staff members caring for eight children (three infants and five preschoolers). The licensee has a large license and is operating within the capacity limits and ratios for this visit.

All adults in the home had obtained criminal record clearances from the California Department of Social Services. All adults living or working in the home are associated with the facility. Emilsa Lima is associated with a different facility, not this facility.

LPA observed that all required documents, such as the facility license, the Notification of Parental Rights, the Earthquake Preparedness Checklist, and the Notice of Site Visit from the pervious visit on 03/28/25 were displayed and visible to the public.



The most recent emergency disaster drill was conducted on 3/7/25, and the LPA observed that it was documented. LPA reviewed the emergency disaster drill log and found they were conducted at least once every six months.

DAY CARE AREA: In Law unit: Living Room, Bedroom #2, bathroom, outside patio, & backyard grass area.
OFF LIMITS AREA: Entire Front house, garage, driveway, and pool area in the backyard.

LPA inspected the indoor and outdoor daycare areas to identify health and safety hazards. The home had a fire extinguisher, a first aid kit, and a combine carbon monoxide and smoke detector. LPA tested the combo carbon monoxide/smoke detector and found it functioning.
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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: PADILLA, MARISOL
FACILITY NUMBER: 414004987
VISIT DATE: 04/14/2025
NARRATIVE
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LPA observed that the home's interior was clean and orderly, with proper heating and ventilation. Disinfectants, cleaning solutions, poisons, and other hazardous items were stored in areas inaccessible to children. The bathroom was clean, fully operational, and equipped with suitable toileting equipment and sanitation products.

LPA observed that the daycare areas had age-appropriate toys, furniture, and educational materials. A designated area was provided for storage of each child's clothing and personal belongings. Electrical outlets were not fitted with child safety covers or tamper-resistant locks to prevent children's access. According to the licensee, there are no firearms or weapons on the property.

The backyard is surrounded by a fence and features a variety of outdoor play equipment, all of which are in excellent condition. The areas around and under high climbing equipment, swings, slides, and similar equipment were observed to be cushioned with grass, artificial grass, or sand. LPA observed a filled pool with a 60 inch fence around it, that meets the pool safety requirements. LPA observed that the gate is self locking, the lock is more than 60" from the ground, the gate opens away from the pool, and there is a life ring. LPA observed that a 12 ft pool hook had been ordered and shipped, but had not arrived yet. LPA did not observe an alarm for entering the pool upon arrival. A pool alarm was purchased and LPA saw it met the requirements before LPA departed. LPA did not observe any other bodies of water on the property. LPA reviewed the pool safety regulations with Lima.

Lima stated that the day care provides breakfast, lunch, and AM/PM snacks for their children. Lima stated that there are no documented allergies among any of the enrolled children. Formula or milk for the infants is provided from home and labeled in the fridge.

The facility offers different options for children to rest or nap, including cots for preschoolers and play yards for infants. LPA observed that sheets and blankets were available for the children, stored in their personal cubbies when not in use. Infant mattresses are firm and equipped with appropriately sized sheets. All play yards are well-maintained and free of loose items that could pose safety risks.

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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
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: PADILLA, MARISOL
FACILITY NUMBER: 414004987
VISIT DATE: 04/14/2025
NARRATIVE
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During the previous visit on 3/28/25, LPA reviewed the files of five children and noted that two of the children were missing some documentation. During the previous visit, LPA informed the licensee of which paperwork was missing. Today, LPA reviewed the files of the two children that previously had incomplete records and confirmed that all necessary forms were present and completed. LPA also reviewed the files for three children that were not present during the pervious visit. LPA found that all the necessary forms were present and correct, with the exception of the LIC 9224. None of the children's files reviewed had LIC 9224. LPA also reviewed the 15-minute sleep records for the three children under two and confirmed they were documented.
LPA reviewed the licensee’s employee files and found that they were incomplete. None of the employees had TB clearance and some were missing immunization records. Per Lima and staff, they have been tested for TB and two are waiting on their chest x-ray results. LPA confirmed that the licensee holds a valid Pediatric First Aid/CPR certification, which is set to expire in September 2026. LPA confirmed that three other adults present at the facility had valid First Aid/CPR, because the licensee was not present today. LPA reminded Lima to maintain immunization records and TB clearance in the staff files. None of the staff had Mandated Reporter Training certificates.

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/.

This facility does not provide Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
LIC809 (FAS) - (06/04)
Page: 4 of 12
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: PADILLA, MARISOL
FACILITY NUMBER: 414004987
VISIT DATE: 04/14/2025
NARRATIVE
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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-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.

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.

TECHNICAL VIOLATION: Violations of the Health and Safety Code (HSC), regulations (CCR), or interim licensing standards (ILS) that do not pose a health, safety or personal rights risk.

LPA issued 3 Type B citations.

Licensee may be called in for an in office visit.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Emilsa Lima, whom was representing the licensee during this visit.

NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025
LIC809 (FAS) - (06/04)
Page: 10 of 12
Document Has Been Signed on 04/14/2025 04:24 PM - It Cannot Be Edited


Created By: Katie Krenn On 04/14/2025 at 03:16 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PADILLA, MARISOL
FACILITY NUMBER: 414004987

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(1)(B)
1596.814(a)(1)(B)(ii)(I)
(ii) (I) An alarm that, when placed in a swimming pool, will sound upon detecting an entrance into the water. The alarm shall be turned on and be in working condition during a facility’s operating hours while the swimming pool is not in use.

This requirement is not met as evidenced by: There is no alarm in the pool, nor cover on the pool.
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2025
Plan of Correction
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Licensee with provide a photo of the alarm in the pool.
Type B
Section Cited
HSC
1597.622(a)(1)
(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by: The staff does not have vaccination records or TB clearance.
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2025
Plan of Correction
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Licensee will provide documentation of immunizations all staff. Documentation shall include DTaP and MMR vaccination or positive antigen testing. Documentation will also include TB clearance. Licensee will keep proof of immunization and TB clearance in files for self and staff.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Daniel J Oquendo
NAME OF LICENSING PROGRAM MANAGER:
Katie Krenn
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2025


LIC809 (FAS) - (06/04)
Page: 11 of 12
Document Has Been Signed on 04/14/2025 04:24 PM - It Cannot Be Edited


Created By: Katie Krenn On 04/14/2025 at 03:24 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PADILLA, MARISOL
FACILITY NUMBER: 414004987

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
(b) (1)   On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by: Mandated Reporter Training Certificates were not available for review.
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in five out of five persons which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/28/2025
Plan of Correction
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Licensee will provide documentation of completion of Mandated Report Training Certificates for self and all employees.
Type B
Section Cited
HSC
1596.8595
(a)(1) Each licensed child day care facility shall post a copy of any licensing report pertaining to the facility that documents either a facility visit or a complaint investigation that results in a citation for a violation that, if not corrected, will create a direct and immediate risk to the health, safety, or personal rights of children in care. Adjacent to the postings required pursuant to Section 1596.817 and on, or immediately adjacent to, the interior side of the main door to the facility and shall remain posted for 30 consecutive days.
(c)(1) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b

This requirement is not met as evidenced by: LPA observed that the report was not posted and the 9224 forms were not available for review.
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited abovewhich posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2025
Plan of Correction
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Licensee will post the report, give copies to all the parents, and have all parents for the next 12 months sign LIC 9224.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Daniel J Oquendo
NAME OF LICENSING PROGRAM MANAGER:
Katie Krenn
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2025


LIC809 (FAS) - (06/04)
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