197493252-1-11-2023-12-CC-JDOY-CMYR22-20230111113738

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493252
Report Date: 01/11/2023
Date Signed: 01/11/2023 11:38:21 AM

Document Has Been Signed on 01/11/2023 11:38 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	NUNEZ FAMILY CHILD CARE		FACILITY NUMBER:	197493252
ADMINISTRATOR:	NUNEZ, JESSICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 963-2512
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93552
CAPACITY:	14	CENSUS: 5	DATE:	01/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Jessica Nunez		TIME COMPLETED:	11:52 AM

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	Licensing Program Analyst (LPA) Justin Dorsey met with Licensee, Jessica Nunez, who guided analyst on a tour of the facility for the One Year Required Inspection. This is a two story home with 4 bedrooms, 2.5 bathrooms, kitchen, dining room, formal dining room, living room, family room (main care area), and garage. There is no pool on the premises. Upon arrival LPA observed 5 children with the licensee. Physical Plant: Main care is provided in the family room. Children use the bathroom in hallway near the garage. Children have access to the family room, children's bathroom and backyard. Off limit areas in the home include the entire upstairs, living room, formal dining room, kitchen and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (inaccessible above washer and dryer near children's bathroom), medicines (locked in children's cubby) and hazardous items (sharp knives locked in kitchen drawer) that can pose a danger to children. Fireplace is screened. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/play equipment were observed on the premises. There is a designated area for ill children as necessary in the dining room. Per Licensee there are no weapon/firearms in the home. The last fire drill was completed 12/04/22. Per licensee she does not conduct earthquake drills, LPA Dorsey gave licensee a copy of the LIC 9148 and advised licensee that the drills must be conducted every six months. Roster complete and maintained current. Bathroom: Children at the home have access to the restroom near the homes garage. LPA Dorsey observed the children's restroom to be free of hazard. Toilet and faucet is clean and operable.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: NUNEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493252
	VISIT DATE: 01/11/2023

NARRATIVE

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Kitchen: Sharp utensils are inaccessible. Per licensee breakfast, AM snack, lunch, PM snack, and dinner (if necessary) are provided. LPA reminded licensee If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Cleaning supplies are stored above the homes washer and dryer near the garage. No chemicals in the kitchen were observed to be accessible.

Outdoor: The backyard is safe for children and completely fenced. The backyard has turf and concrete areas for children to play. LPA observed the toys in the backyard to be in safe condition. During the visit the licensee stated the left side of the homes back yard is currently off-limits. This area is gated and includes a wooden play structure and swings. Per licensee this area will remain off-limits until the play structure is removed. Per licensee children in care do not use this area.

Advisory/Other: First Aid kit was readily available. CPR/First Aid expire 08/19/24. Mandated Reporter was completed 05/10/22. Per licensee assistant #1 began working at the home on 01/09/23 and she has not received their required documents. LPA Dorsey went over and gave a copy of the Title 22 102416.1 Personnel Records and required assistant documents with the licensee. Children nap on mats and cribs in the family room.

Documents discussed: Title 22 102416.1 Personnel Records, Safe Sleep PIN 20-24-CCP, LIC 9227 and Infant Sleep Log.

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 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.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: NUNEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493252
	VISIT DATE: 01/11/2023

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A notice of site visit was given and must remain 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 Jessica Nunez.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC809 (FAS) - (06/04)

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