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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004980
Report Date: 11/20/2024
Date Signed: 11/20/2024 04:16:09 PM

Document Has Been Signed on 11/20/2024 04:16 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:OLAZABAL, DEYSI MARGARITAFACILITY NUMBER:
414004980
ADMINISTRATOR/
DIRECTOR:		OLAZABAL, DEYSI MARGARITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 450-1983
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 3DATE:
11/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Licensee, Deysi Margarita OlazabalTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
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On November 20th, 2024 at approximately 2:30pm, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced annual/random inspection. LPA met with Licensee, Deysi Margartia Olazabal and explained the purpose of the inspection. Present in the facility are licensee and assistant caring and supervising 3 infant children. All adults present today have fingerprint clearance and are associated.

Licensee rents one story duplex, which is a two bedroom one bathroom home with back yard and garage. Licensee lives in the home with two minor children. The hours of operation are Monday-Friday from 8am-5pm. Daycare area are: Living Room, Dining Room, Bathroom #1, Bedroom #1, and backyard. OFF limit areas: Bedroom #2, kitchen, and Garage. All off limit areas are properly barricaded, including closets.



LPA observed home to be clean and in good repair with proper temperature and ventilation. There were a variety of age appropriate toys and equipment in the home which were in good condition. Home does not have a fireplace, Home has open face heaters in the home that is properly . There are pets in the home with proper documentation. There were no pools, spas or bodies of water on the property. LPA advised licensee about water safety hazards. All cleaning supplies, poisons, and other chemicals were stored inaccessible to children. Discipline Policy was discussed. Isolation Area a sick child will be in the room.

There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed for Licensee is updated in the system. Per Licensee, there are no weapons or firearms in the home. Infant children are sleeping in cribs in the bedroom. Sleep logs are being properly logged for each infant child.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: OLAZABAL, DEYSI MARGARITA
FACILITY NUMBER: 414004980
VISIT DATE: 11/20/2024
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LPA reviewed 3 children's file and facility files. Children's files were complete. Facility files were completed. Licensees CPR & First Aid Certificate expires on 01/2026. Licensee's Mandated Reporter Certificate has expired 07/2024. Last emergency drill was conducted 07/2024. LPA reminded that Emergency Drills must be conducted at least once every six months and be properly logged. All the required posting documentation, such as the facility license, Notification of Parental Rights have been placed in a prominent area for parents or representatives to review.

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 atwww.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Licensee was reminded that all adults 18 and over, 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 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 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.



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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: OLAZABAL, DEYSI MARGARITA
FACILITY NUMBER: 414004980
VISIT DATE: 11/20/2024
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Incidental Medical Services (IMS) policy was discussed. Licensee does not offer IMS at this time. 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 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, Deysi Margarita Olazabal, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 11/20/24.

***Deficiencies were not cited today under California Code of Regulations, (Title 22, Div. 12, Ch 3)



A Notice of Site Visit was given and must be posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Deysi Margarita Olazabal.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
LIC809 (FAS) - (06/04)
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