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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005025
Report Date: 10/17/2024
Date Signed: 10/17/2024 11:27:20 AM

Document Has Been Signed on 10/17/2024 11:27 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MERIDA, HEALYN A.FACILITY NUMBER:
414005025
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
10/17/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:55 AM
MET WITH:Licensee, Healyn MeridaTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On October 17, 2024, at approximately 10:55 am, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, case management visit. LPA met with the licensee Healyn Merida and explained the purpose of the visit. Present during LPA's visit included the licensee and 6 children (3 infant and 3 preschool age).

Licensee requested to increase capacity from a small family child care home to a large family child care home. Capacity increase application was submitted to the department October 8, 2024. Fire clearance approval has not been obtained. Per licensee, they are waiting to schedule an appointment with The Fire Department.

Licensee Healyn Merida lives in the home with their 2 children. Licensee was reminded if children live in the home under 10 years old, they are counted towards overall capacity. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are Monday through Friday 7:30am to 5:30pm

The DAY CARE AREAS now approved are the living room, dining room, bathroom #1, bedroom #1 (napping room), and backyard. The OFF LIMIT AREAS are the kitchen, bedroom #2, bedroom #3, bathroom #2, and garage. Off limit areas are made inaccessible with child safety door handles and/or a child safety gates. Home is equipped with a fully charged fire extinguisher, first aid kit and smoke and carbon monoxide detectors. LPA observed smoke and carbon monoxide detector in hallway

Capacity limits and ratios for a large family day care have been reviewed with the licensee on this date. LPA reminded licensee that an assistant must be present when operating as a large license. LPA reminded licensee when an assistant is not present, licensee must operate within capacity limits of a small family child care home.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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: MERIDA, HEALYN A.
FACILITY NUMBER: 414005025
VISIT DATE: 10/17/2024
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The licensee has obtained a signed Property Owner/Landlord Consent Form (LIC 9149).

LPA will not approve license for a capacity of 14 children until Fire Clearance Approval is obtained.

No deficiencies were issued during today's visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Healyn Merida
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
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