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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410518531
Report Date: 07/22/2026
Date Signed: 07/22/2026 03:50:52 PM

Document Has Been Signed on 07/22/2026 03:50 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:NAVARRETE, GLORIA L.FACILITY NUMBER:
410518531
ADMINISTRATOR/
DIRECTOR:		NAVARRETE, GLORIA L.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 873-6956
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 5DATE:
07/22/2026
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Licensee, Gloria Navarrete TIME VISIT/
INSPECTION COMPLETED:
04:10 PM
NARRATIVE
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On July 22, 2026, at approximately 11:00AM, Licensing Program Analyst (LPA) Alvarado arrived to the facility to conduct an unannounced annual visit. LPA met with the Licensee Gloria Navarrete(L1) and explained the purpose of the visit. Present during the visit was (L1) and assistant supervising 5 children (1 Infant and 4 Preschoolers). Facility is a large license and is operating within ratio and capacity as of today’s inspection. (L1) confirmed that residents who reside in the home are (L1) and husband. All adults present during today’s inspection have fingerprint clearance and are associated with the facility.

Daycare Areas: Family Room, Bedroom #1, Bedroom #2, Bathroom #1, and Front Yard.
Off-limits Areas: Kitchen, Bedroom #3, Master Bedroom, Living Room, Garage and Backyard.

LPA along with (L1) conducted an inspection indoors and outdoors for any health or safety hazards. The home is equipped with a fully charged 2A10BC fire extinguisher located in the living room and in the kitchen. carbon monoxide detector located in the hallway was tested and observed to be functioning during today’s inspection. LPA also tested and observed that the smoke alarm was functioning during today’s inspection. There is a fireplace in the Family Room that has been barricaded to be inaccessible. Electrical outlets are covered or blocked by furniture when not in use. The facility’s operating hours are from 7:00AM to 6:00PM.

LPA observed there to be age-appropriate toys and learning materials present. Furniture is age-appropriate and free of rough or sharp edges. Children nap in cribs and beds that are provided by the facility. Per (L1) facility provides breakfast, lunch and snack. Per (L1) some families also pack snack for children that LPA observed to be located in individually packed lunch bags. LPA suggested that the licensee in the refrigerator to have a designated space for children belonging only so that they are not mixed in with any other items that are not for children.

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Ali Zebila
Diana Alvarado
DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2026
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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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)
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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: NAVARRETE, GLORIA L.
FACILITY NUMBER: 410518531
VISIT DATE: 07/22/2026
NARRATIVE
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Per (L1) there are no firearms present in the facility. All chemicals and Poisons are locked and made inaccessible to children. Phone number listed on file for Licensee is current number. LPA observed that that Emergency Drills have been documented, and LPA reminded (L1) that Emergency Disaster Drills must continue to be Conducted and Documented once every six months.

LPA inspected the outdoor space along with (L1), Outdoor space is in the front yard of the home. LPA observed many toys and children equipment, LPA reminded (L1) to discard any todays that might have broken over time and to do a sweep through prior to stepping outdoors. LPA also suggested that the green tarp that is grass alike to be reinforced so that it does not lift. LPA also suggested that any high climbing areas such as swings have resilient padding to be added to for extra precautions. Per (L1) outdoor space gets used if weather permits and at times will go for walks to a nearby park.

No pools, hot tubs, spas, fishponds or similar bodies of water observed on the property. The license also confirmed no bodies of water on property. License was reminded that Babywalkers, bouncers, jumpers and similar items will not be used for children in care and are not allowed and were not observed by LPA.

LPA conducted personnel record review for (L1) and assistant. (L1) and assistant have current CPR/First Aid that will expire at the end of 5/2027. (L1) and assistant also have updated and completed Mandated Reporter Training that expires 5/2027. (L1) was reminded that CPR/First Aid and Mandated Reporter Training needs to be renewed every two years and renewed for all additional staff who are providing care and supervision. LPA observed as well that proof of a few immunization's were not available for review.

LPA conducted children record review for 5 children’s files, LPA observed that two children files were incomplete. LPA also reviewed facility records, and a few Required postings were observed to be posted LPA informed (L1) on the missing forms. Safe Sleep was discussed with (L1) as Documentation of 15-Minute Sleep logs have not been conducted or maintained. LPA provided facility with the Entrance Checklist for Family Child Care Homes (LIC 126).

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
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: NAVARRETE, GLORIA L.
FACILITY NUMBER: 410518531
VISIT DATE: 07/22/2026
NARRATIVE
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At approximately 1:30, one child was picked up from the facility and (L1) had to step out of the facility at 2:05PM for an appointment and arrived at 3:15.

Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for and removing any 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. When any IMS is provided, 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)/ (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee [or facility representative] 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.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
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: NAVARRETE, GLORIA L.
FACILITY NUMBER: 410518531
VISIT DATE: 07/22/2026
NARRATIVE
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During the exit interview, the Licensee Gloria Navarrete, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

See LIC 809-D for deficiencies being cited today on July 22, 2026 under the California Code of Regulations, Title 22, Division 12, Chapter 1. Regarding Physical Plant and Records.

See LIC9102-TV for Technical Violation issued today regarding Physical Plant and Facility Administration.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were provided to the Facility. Exit interview conducted and report was reviewed with the Licensee, Gloria Navarrete.
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/22/2026 03:50 PM - It Cannot Be Edited


Created By: Diana Alvarado On 07/22/2026 at 02:55 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: NAVARRETE, GLORIA L.
FACILITY NUMBER: 410518531

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in the Emergency Disaster Plan has not been posted or was able to be obtained during record review which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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Facility will be provided with a blank Emergency Disaster Plan, that needed to be filled out completely a photo sent via email to LPA Alvarado by 7/31/26 and proof of posting. Facility will be provided again with the Facility entrance checklist (LIC 126) for reference of required postings.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in which required Immunizations were not available for review for both the licensee and assistant which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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Facility will ensure obtain proof of immunizations and place of facility personnel records. LPA reminded the licensee that required immunizations are measles, pertussis, influenza and proof of Tuberculosis (TB) and should be maintained on file for department review. LPA also provided the Facility entrance checklist (LIC 126) for reference of requirements in the personnel records. Facility will submitt proof to LPA Alvarado by 7/31/26 via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:
Diana Alvarado
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2026


LIC809 (FAS) - (06/04)
Page: 6 of 12
Document Has Been Signed on 07/22/2026 03:50 PM - It Cannot Be Edited


Created By: Diana Alvarado On 07/22/2026 at 02:55 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: NAVARRETE, GLORIA L.
FACILITY NUMBER: 410518531

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(b)
Child's Records
(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required
in Section 102417(g)(7).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in one child did not have the required emergency information card as well as having an incomplete file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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Facility will ensure to provide the families for Owen and Autumn the forms that are missing. Children are siblings and Facility was reminded that each child needs to have their own form. LPA provided the Facility entrance checklist (LIC 126) for reference of required forms for children records that include the emergency information card.
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above by not logging infant sleep checks every 15 minutes which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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Infant sleep logs shall be maintained for all infants (0-24 months). Sample sleeping log was provided during the visit. The facility shall maintain infant sleeping logs and have them available for review. Facility will submitt proof to LPA Alvarado of maintained sleep logs by 7/31/26 via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:
Diana Alvarado
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2026


LIC809 (FAS) - (06/04)
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