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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005137
Report Date: 08/08/2024
Date Signed: 08/08/2024 05:31:54 PM

Document Has Been Signed on 08/08/2024 05:31 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:RODRIGUEZ, CONSEPCIONFACILITY NUMBER:
414005137
ADMINISTRATOR/
DIRECTOR:		RODRIGUEZ, CONSEPCIONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 465-3804
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/08/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:24 PM
MET WITH:Consepcion RodriguezTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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On August 8, 2024, @ approx. 1:30 pm, Licensing Program Analyst (LPA)Maria Olguin-Leon conducted an announced, pre-licensing relocation inspection. LPA and met with applicant Consepcion Rodriguez and explained the purpose of the inspection. Applicant submitted a relocation application to our department on July 18,2024. Applicant has relocated from Facility #414004828 to this location. Fire clearance was received on July 30, 2024. Hours of operation will Monday-Friday from 7:30AM to 5:00PM. Applicant plans to provide care to children ages: 0 mths. – 5 yrs. old. Applicant lives in single story level home with spouse and two adult children. All adults living in home have criminal background clearances. Present during today’s visit was applicant.

With applicant, LPA inspected the indoors and outdoors of the home for health and safety hazards. Applicant owns this single-story home that consists of a living room, dining room, kitchen, hallway, 3 bedrooms 1-bathroom, detached garage, and backyard. The DAY CARE AREAS are the living room, dining room, hallway (walk through to bathroom and walk through to hallway kitchen entrance) and backyard. The OFF-LIMIT AREAS are all three bedrooms, kitchen (walk through to backyard) and detached garage. Applicant was notified any off-limit areas are not to be used as a day care area without prior approval from department.

LPA observed the following: Home was clean and orderly. Living room is equipment with plenty of age-appropriate toys, toy storage cubbies, child size furnishing, books and foam mat to cushions fall. LPA observed playpens and cots for napping children in dining room. LPA observed playpen to be free of loose articles and materials. Applicant plans to provide sheets for playpens/cots and will wash weekly. Cubbies and changing table are secured and anchored to walls. Per applicant, children will always be supervised while in bathroom and walking through kitchen and will store all detergents, cleaning compounds, medications and other items which could pose a danger in off limits areas. All electrical outlets are properly covered with child proof cover. Home is equipped with child proof gates at both entrances of kitchen and in hallway. Fireplace is properly barricaded with an infant coordination mirror.

Cont. page 2...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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 4
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: RODRIGUEZ, CONSEPCION
FACILITY NUMBER: 414005137
VISIT DATE: 08/08/2024
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LPA advised applicant to install cushioning on brick/rock flooring of fireplace. Backyard has cement patio and artificial grass area to cushion fall. Backyard is equipped with two sunshades to provide shade to children in care. Backyard is equipped with a ride on toys, applicant is in process of moving outdoors toys into new location. There is a 5 ft. fence surrounding entire backyard and gate to alley is equipped with a lock. LPA did not observe any spas, pools, or other bodies of water.

Home is equipped with a working smoke detector and a carbon monoxide detector. LPA observed a fully charged fire extinguisher in living room. LPA observed a first aid kit fully stocked with necessary supplies. Applicant uses a designated cell phone and is aware the cell phone must stay within the home during the day care hours. Isolation area for sick children will be in dining room and away from other children and where applicant can supervise all children in care. Per applicant, there are no weapons or firearms in the home. Applicant will use calming techniques and talking to children for discipline techniques.

LPA reviewed the LIC311D, Records to Keep in Your Family Child Care Home, children’s forms/ records, facility forms, and information to be posted. Entrance Checklist LIC 126 was provided to the applicant. Applicant’s CPR/First Aid certification will expire 09/2024. Applicants Mandated Reporter training certificates (AB1207) is current that will expire 07/2025.

LPA and applicant discussed licensing regulations and the capacity requirements. Any children under 10 years of age that live in the home, will be counted in overall capacity. Capacity limits and ratios for a large family day care were reviewed with 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 as a small license.

Applicant plans to provide meals: two snacks, breakfast, and lunch. LPA reminded applicant to label all food brought from home with child’s name and to store food properly. LPA discussed sanitation and allergies with applicant.


Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: RODRIGUEZ, CONSEPCION
FACILITY NUMBER: 414005137
VISIT DATE: 08/08/2024
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Applicant understands the required emergency disaster drills are to be conducted and documented at least once every six months. Applicant understands that the use of baby walkers, bouncers, jumpers, and similar items are not to be used for children in care. Smoking is prohibited inside a Family Childcare Home.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.



This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with applicant 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 [applicant, licensee, or facility representative] 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.

Cont. page 4...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: RODRIGUEZ, CONSEPCION
FACILITY NUMBER: 414005137
VISIT DATE: 08/08/2024
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On this date, 07/22/2024, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Prior to licensure, following is to be completed:
-Install padding around fireplace.
-Post all required licensing documents.
Applicant will send LPA photos.

Exit interview conducted and report was reviewed with the applicant, Consepcion Rodriguez. Visit was conducted and report translated in Spanish.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
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