<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005272
Report Date: 08/21/2025
Date Signed: 08/21/2025 02:58:59 PM

Document Has Been Signed on 08/21/2025 02:58 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, TIFFANYFACILITY NUMBER:
414005272
ADMINISTRATOR/
DIRECTOR:		PADILLA, TIFFANYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 315-8936
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/21/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Tiffany PadillaTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On August 21, 2025, at approximately 1:00 PM, Licensing Program Analyst (LPA) Katie Krenn conducted a scheduled pre-licensing follow up visit at the address listed above. LPA met with Applicant, Tiffany Padilla and explained the purpose of the visit. Applicant has applied for a large Family Child Care Home License.

Currently, the applicant’s planned operating hours will be from 8:00AM to 4:30PM, Monday to Friday.
All adults living in the home have received fingerprint clearance.
Applicant rents the home and has given landlord notification.
Daycare Areas: Living Room, Dinning Room, Kitchen, Bathroom #1 (Hallway), and a portion of the backyard.
Off-Limits Areas: Laundry Room, Hallway (pass-through only), Bedroom #1, Bedroom #2, Bedroom #3 Bathroom #2, Front Yard, Driveway, and Garage.

Applicant confirmed that there are no swimming pools, spas, or other similar bodies of water present.

LPA verified that Applicant’s phone number and email address were current during the visit.

LPA and Applicant inspected the home for any health or safety hazards. Applicant is still in the process of updating the home and moving in. LPA inspected the home and the backyard. LPA observed a fully charged 3A40BC fire extinguisher and a fully stocked first aid kit.

LPA observed that the home was clean and in excellent condition. LPA observed that the bathroom fixtures were operational, equipped with suitable toileting materials, and had step stools to aid children’s access to the facilities. None of the accessible drawers or cabinets contained any toxic or hazardous materials.
continued on page 2
NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/21/2025
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
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)
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: PADILLA, TIFFANY
FACILITY NUMBER: 414005272
VISIT DATE: 08/21/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 2
Applicant has removed the carpet in the day care areas and replaced it with new vinyl flooring. LPA observed that electrical outlets in the daycare areas were covered to prevent children’s access. LPA observed a child lock to prevent children’s access to the laundry room. There were other child locks in the kitchen to prevent children’s access. LPA observed additional child’s locks for the kitchen. Applicant will send photos or video once they are installed.

LPA observed the progress that has been made on the back yard. The electrical meter was made inaccessible to children and the water pipe was covered to prevent children’s access or injury. LPA observed that the fountain is being filled with flowers, some of the planter beds have been filled to be level with the paving, tall sprinklers are being capped off, and Applicant has purchased a mesh fencing that is long enough to section off the backyard.

Inside the home, LPA observed that the mechanisms for the old curtains had been removed. The curtains were replaced with a pull-down shade and the new curtains do not require a mechanism for closure. LPA observed that the previously exposed metal handle that turns to open the windows have been appropriately covered. The fireplace has been made inaccessible using a portable barrier. The TV has been secured to the furniture.

LPA observed that applicant has covered the accessible heating and cooling registers in the daycare areas to prevent children’s access. LPA observed that applicant has prepared the parent’s board with the necessary postings such as the Notification of Parent's Rights Poster (PUB 394), the Earthquake Preparedness Check List (LIC9148), and the Emergency Disaster Plan (LIC 610A) were posted at the entrance where children will be dropped off and picked up by their caregivers.

LPA observed age-appropriate toys, cots, furniture, and educational materials. Applicant does not plan to have children under the age of 15 months. LPA reviewed safe sleep regulations and reminded Applicant that 15-minute sleep checks are required for children under 24 months.

Applicant will provide meals through a meal program and will post menus.

LPA observed evidence that the applicant lives in the home. LPA did not review the pre-licensing packet or review documents, because that was done during the previous visit.
continued on page 3
NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
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: PADILLA, TIFFANY
FACILITY NUMBER: 414005272
VISIT DATE: 08/21/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 3
LPA requires photo and/or video documentation of the following:
- The empty fountain will be completely filled in.
- Planters in the day care area filled so they are flushed with the paved area.
- The sprinklers that extend past the area to be filled, will be capped off.
- The lattice structure around a locked shed will be made inaccessible with a barricade until it can be repaired.
- The fence to separate the backyard will be installed.
- Applicant will provide photos that all the accessible cabinets and drawers in the kitchen will have child safety locks or be free of hazardous materials.
- Applicant will obtain fire inspection approval.

Upon LPA’s receipt and review of the documentation of completion of the items listed above, LPA will issue a large Family Child Care Home license to the Applicant.

To improve the quality and value of the inspection process, a survey will 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 tools, please send them by email 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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/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 [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.

Exit interview conducted and report was reviewed with the applicant, Tiffany Padilla.
NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4