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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005152
Report Date: 09/10/2024
Date Signed: 09/27/2024 04:02:59 PM

Document Has Been Signed on 09/27/2024 04:02 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:BARBIN, GABRIELA A.FACILITY NUMBER:
414005152
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/10/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:29 AM
MET WITH:Gabriela BarbinTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
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On September 10, 2024, @ approx. 9:30am, Licensing Program Analyst (LPA)Maria Olguin-Leon conducted an announced, pre-licensing relocation inspection visit. LPA met with applicant, Gabriela Barbin and explained the purpose of the inspection. Applicant submitted a relocation application to our department on August 30, 2024. Applicant has relocated from facility #414005002 to this location. Hours of operation will Monday-Friday from 8:00am to 6:00pm. Applicant plans to provide care to children ages 0 months to 10 yrs. old. Applicant lives in the home with spouse and minor child. Present during today’s visit was applicant and no children. All adults living in home have criminal background clearances.

With applicant, LPA inspected the indoors and outdoors of the home for health and safety hazards. Home is a two-level story home; downstairs consist of entrance foyer, living room, family room, kitchen/dining room, laundry room, bathroom, and garage. Second floor consist of 5 bedrooms, bathroom, and. master bathroom. The DAY CARE AREAS: are entrance foyer, living room, family room and bathroom, bedroom #2 and #4 for napping only and backyard. The OFF-LIMIT AREAS the kitchen/dining room, laundry room, garage, bedrooms #1, #3, #5, upstairs bathroom, and master bathroom. Applicant was notified any off-limit areas are not to be used as a day care area without prior approval from department. Applicant understand applicant will need to be on the same floor where children are napping.

LPA observed the following: Home was clean and orderly. Living room and family room are equipped with plenty of age-appropriate toys, learning material, toy storage cubbies, children’s cubbies, and rugs to cushion falls. Applicant will provide sheets for mats and applicant will wash weekly. Bathroom is equipped with a training potty seat and toiletries for children. Fireplace is properly barricaded with a toy storage cubbies and brick surrounding fireplace Is secured with an edging corner protector. All electrical outlets are properly covered with child proof covers. One kitchen entrance is secured with child proof retractable gates. Bottom of staircase is secured with a retractable child proof gate. Backyard is equipped with plenty of age-appropriate toys that consist of sandbox, climbing/slide structure, swing set with attached trampoline, playhouse, and children’s table. Backyard flooring consist of a cement patio and dirt/dry grass under play structures. There is a 5 ft.wood fence surrounding entire backyard. LPA did not observe spas, pools, or other bodies of water.

Cont. page 2...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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: BARBIN, GABRIELA A.
FACILITY NUMBER: 414005152
VISIT DATE: 09/10/2024
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Home has ventilation and lighting throughout. Per applicant, off-limit closets will remain closed and locked during operating hours. LPA observed laundry room to have a child proof lock. All detergents, cleaning compounds, medications and other items which could pose a danger are stored inaccessible to children behind child safety locked cabinets and/or located in off limit areas. Per applicant, there are no weapons or firearms in the home. Applicant currently carries liability insurance with Aegis insurance.

Home is equipped with working smoke detector, working carbon monoxide detectors, and a new 2-A:10BC fire extinguisher, which is stored in kitchen. 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 living room or family room; away from other children and where applicant can supervise all children in care. Applicant will redirection them 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 was provided to the applicant. Applicant’s CPR/First Aid certification is current and will expire 05/2026. Applicants Mandated Reporter training certificates (AB1207) is current that will expire 02/2025.

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. Applicant plans to provide meals: snack, breakfast, and lunch. LPA discussed sanitation and allergies with applicants. LPA reminded Applicant to label all food brought from home.

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.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC809 (FAS) - (06/04)
Page: 4 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: BARBIN, GABRIELA A.
FACILITY NUMBER: 414005152
VISIT DATE: 09/10/2024
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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.

The applicant provided proof of control of property. The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 [or 12] children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 [or 14] children.

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: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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: BARBIN, GABRIELA A.
FACILITY NUMBER: 414005152
VISIT DATE: 09/10/2024
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On this date, 09/03/2024, 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 childproof gate at top of stairs, 2nd entrance to kitchen and both sides of backyard
-Post all required licensing documents.
-Cover/cushion faucets outside
-anchor swing set to ground
-First aid kit
-Fire inspection clearance for large capacity approval, applicant will submit increase of capacity application to office.
Applicant will send LPA photos, once completed.

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

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC809 (FAS) - (06/04)
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