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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304310791
Report Date: 07/30/2024
Date Signed: 07/30/2024 10:30:32 AM

Document Has Been Signed on 07/30/2024 10:30 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GOMEZ-ZUNIGA, INESFACILITY NUMBER:
304310791
ADMINISTRATOR/
DIRECTOR:		GOMEZ-ZUNIGA, INESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 606-3913
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92672
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
07/30/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Licensee Ines Gomez-ZunigaTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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On 07/30/2024 at 9:25 a.m., Licensing Program Analyst (LPA), Christine Jung, conducted an unannounced case management – legal/noncompliance inspection. Upon arrival, LPA met with Licensee, Inez Gomez-Zuniga, and was led on a tour of the facility. There were seven (7) children including one (1) infant, two (2) assistants, and one (1) volunteer present. The facility was operating within teacher-child ratios and licensed capacity.

Facility Personnel Report Summary review indicated all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During the visit, the LPA reviewed the procedures agreed upon during the Noncompliance Conference (NCC) on 10/19/2023. Upon arrival the LPA observed children in the main daycare area engaged in play. LPA took a census and confirmed the facility was operating within ratio and licensed capacity. LPA observed baby gates and doorknob covers ensuring inaccessibility to off-limit areas. In the backyard, LPA observed a baby gate was installed to ensure that children do not have access to plants. LPA did not observe any items that could pose a danger to children in the backyard. LPA reviewed infant file to ensure licensee is following Safe Sleep procedures. LPA reviewed LIC 9227 Individual Infant Sleeping Plan and Safe Sleep Log for daily 15-Minute checks. LPA observed play yards and mats were available for children’s nap.

No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Ines Gomez-Zuniga.

(End of Report)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2024
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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