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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005500
Report Date: 08/01/2024
Date Signed: 08/01/2024 03:11:46 PM

Document Has Been Signed on 08/01/2024 03:11 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:TAVARES, ELISABETH BP & TAVARES.ISADORAFACILITY NUMBER:
214005500
ADMINISTRATOR/
DIRECTOR:		TAVARES, ELISABETH BP.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 996-3416
CITY:CORTE MADERASTATE: CAZIP CODE:
94925
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
08/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:19 PM
MET WITH:Elisabeth TavaresTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On August 1, 2024, Licensing Program Analyst (LPA) Garcia arrived at the facility to conduct an unannounced Annual Inspection and met with the Licensee, Elisabeth Tavares. Purpose of the inspection was explained. There were 12 children present with the licensee and two employees and her adult daughter, during the visit. There were 8 preschool aged and 4 infant children. LPA verified the background check clearance of the adults working or living in the home. The hours of operation are Monday through Friday, 07:30 AM - 5:30 PM. Licensee provides breakfast, AM/PM snacks and lunch. The water is provided by the licensee through filtered water.

Daycare areas: bedroom#1, bedroom #2, living room, back yard and bathroom.
Off Limit areas: Kitchen and bedroom #3, bathroom, from the rest of the house

LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care.
LPA and Licensee inspected the entire childcare area for Health and Safety hazards. There are multiple carbon monoxide and smoke detectors located in each room. LPA did not perform the tests to check the functionality of the detectors due to children napping. One fully charged fire extinguisher of size 3A40BC was also available in the home, located by day care room. First Aid kit is fully stocked and accessible, located in the day care area counter. Licensee states, there are no guns or weapons, open bodies of water in the facility.

LPA observed that the house is in good repair and free of hazards with proper temperature and ventilation and lighting. At 1:20PM, LPA Garcia observed a rodent was roaming around the kitchen floor. At 2:04 PM, the pest control arrived at the facility. LPA observed that there are variety of age-appropriate toys, books, and other learning materials available in the home. Electric outlets have proper covers and a working phone is on site. The Licensee has liability insurance available.

LPA observed that the back yard has grass and playhouses/sets available and in good working condition. There were multiple cars for children to ride on. The play yard also has bins and closets for materials to be stored when not in use. The back yard has swings and slides and the surrounding area are properly barricaded.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: TAVARES, ELISABETH BP & TAVARES.ISADORA
FACILITY NUMBER: 214005500
VISIT DATE: 08/01/2024
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All posting requirements are met and posted near the childcare entrance. Licensee has current and valid CPR and First Aid card which expires on 8/2024. Licensee and employees possess valid Mandated reporter training certificates. The licensee conducts fire and earthquake drills with the children at least every 6 months with most recent one on June 10, 2024. LPA reviewed 3 staff files and 3 children's files. LPA observed all necessary documents are filed for both staff and children. According to the licensee, she would like to request to remove her daughter who is included in the license, to be removed because she does not reside in the home anymore.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information 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: on see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the www.ada.gov/childqanda.htm.



The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

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.

LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: TAVARES, ELISABETH BP & TAVARES.ISADORA
FACILITY NUMBER: 214005500
VISIT DATE: 08/01/2024
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LPA encouraged the Licensee to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at [email protected] and ask to be added to the email list for the updates.

To improve the quality and value of the new 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 [email protected]. 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/process.



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 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.

See 809D for deficiency cited during today's visit.

A copy of this report is given to the Licensee with the notice of site visit. Notice of site visit must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Elisabeth Tavares and her daughter, Hana Tavares..
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/01/2024 03:11 PM - It Cannot Be Edited


Created By: Nathan Garcia On 08/01/2024 at 03:04 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: TAVARES, ELISABETH BP & TAVARES.ISADORA
FACILITY NUMBER: 214005500

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(b)
Operation of A Family Child Care Home
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation), the licensee did not comply with the section cited above in which a rodent was in the kitchen floor, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/02/2024
Plan of Correction
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The licensee initially contacted pest control prior to LPA visit. Licensee contacted the pest control and they came on the same day to inspect the facility and install traps. Deficiency cited today will also be cleared.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Daniel J Oquendo
LICENSING EVALUATOR NAME:Nathan Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024


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