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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405122
Report Date: 01/08/2020
Date Signed: 01/08/2020 04:16:38 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:NUNES, LAURA KFACILITY NUMBER:
073405122
ADMINISTRATOR:NUNES, LAURA KFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 798-0577
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:14CENSUS: 7DATE:
01/08/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Nunes, LauraTIME COMPLETED:
04:45 PM
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LPA, Hollie, arrived at the facility and knocked on the door around 2:05 and did not receive a response. A card was left on the door. LPA prepared to leave when I observed several children coming from what appeared to be school. LPA observed several teenage children enter the house of the licensee. LPA came to the door of the licensee and her teenage child answered and stated that the licensee was not home, but her grandmother was upstairs. Upon entering the home, LPA observed seven teenagers in the home (one of which is the licensee's daughter). Although the licensee's mother is present, she was not downstairs supervising or caring for children. The licensee's daughter contacted licensee who was at Vahalla Elementary School, picking up additional children. LPA spoke with the licensee by phone and the licensee stated that none of the teenagers present were a part of her day care, but rather her daughter's friends. After the phone call the teenagers, put on their shoes and took their back packs and left the home. Shortly after arriving at the facility, the licensee arrived with six day care children.
The licensee was advised that because she holds a day care license, it appears that the teenagers are apart of her day care and she is not present as required. PLEASE SEE ADVISORY NOTICE. During this Random Visit, A tour of the home was conducted. There is a working smoke detector, a fire extinguisher and a charged 2a10bc fire extinguisher.
PLEASE SEE NEXT PAGE FOR CONTINUED REPORT
SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: NUNES, LAURA K
FACILITY NUMBER: 073405122
VISIT DATE: 01/08/2020
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A tour of the ON LIMITS portion of the home was conducted, which is downstairs. The licensee understands that the OFF LIMITS portion of the home (upstairs) must remain inaccessible to children at all times. There are no bodies of water or fire arms on the premises, per the licensee. The Licensee is present in the home and ensures that children are supervised. The Licensee understands that children are not to be placed in locked cars.

The home is orderly with heating and ventilation for safety and comfort. Poisons, detergents, cleaning compounds, medications and other items which could pose a danger to children, are inaccessible during this visit. Fireplaces and open face heaters are screened to prevent access by children. There is a charged 2a10bc fire extinguisher and a working smoke detector as well as a carbon monoxide detector in the home.

Although the licensee does not care for infants, LPA provided the licensee with the Safe Sleep Concepts as it relates to children under the age of one.

PLEASE SEE NEXT PAGE FOR CONTINUED REPORT.

SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020
LIC809 (FAS) - (06/04)
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: NUNES, LAURA K
FACILITY NUMBER: 073405122
VISIT DATE: 01/08/2020
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There are stairs in the home. The home has toys, play equipment and materials for children. The licensee is aware that when she is temporarily absent from the home, she must ensure that a fingerprint cleared adult is present with current CPR/First Aid and have verification of immunization that includes Measles, Pertussis and Influenza (optional) or provide medical exemption signed by their Physician. The facility is operating within her licensed capacity today. There are comfortable accommodations, furnishings and equipment for children. There is a current roster and LPA took a photo of the roster. The licensee has current CPR/First Aid which expires 03-21.The licensee understands that all person’s 18 years of age or older, who frequently visits, works or resides in the home, shall be fingerprint cleared/associated to the home and have immunization's, PRIOR to being in the presence of children. LPA reviewed a sampling of children’s records for documentation of Immunization and Notification of Parents Rights. The home conducts and documents fire drills as required. The licensee was informed that parents should shown the Disaster Plan and be informed of the Relocation Sites in case the Family Day Care home has to evacuate.

PLEASE SEE NEXT PAGE FOR CONTINUED REPORT

SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: NUNES, LAURA K
FACILITY NUMBER: 073405122
VISIT DATE: 01/08/2020
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The licensee has the required immunization's on file.

The back yard continues to be fenced. Children play on The home has one pets.

LPA encouraged the Licensee to review our website at CCLD.CA.GOV to stay up to date and informed on Laws and Title 22 Regulations as it relates to her day care business. Licensee was informed that she can view CCLD’s website for Provider Information by the PINs.


There are no children that require Incidental Medical Services, per the licensee. The licensee's mandated reporter certificate expired 2 weeks ago. The licensee was instructed to take the training again at ccld.ca.gov
LICENSEE WAS INFORMED THAT IF THE FACILITY IS ISSUED A DEFICIENCY NOTICE, THE PLAN OF CORRECTION MUST BE CORRECTED BY THE DATE PROVIDED OR A CIVIL PENALTY OF $100 PER DAY WILL BE ASSESSED TO THE FACILITY UNTIL THE DEFICIENCY IS CORRECTED. ADDITIONALLY, A REPEAT VIOLATION OF A DEFICIENCY WILL BE ASSESSED IN THE AMOUNT OF $250 AND $100 PER DAY UNTIL CORRECTED. THE LICENSEE WAS ADVISED TODAY AS IT RELATED TO HAVING HER "DAUGHTER'S FRIENDS" AT THE DAY CARE. PLEASE SEE ADVISORY NOTES

THERE ARE NO DEFICIENCIES CITED DURING THIS VISIT.

SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4