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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313617066
Report Date: 02/18/2020
Date Signed: 02/18/2020 02:17:00 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:BUNGER, ALEXANDRIAFACILITY NUMBER:
313617066
ADMINISTRATOR:BUNGER, ALEXANDRIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 899-9603
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY:14CENSUS: 8DATE:
02/18/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Effie GreerTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Amanda Blesi arrived unannounced for the purpose of an unannounced Annual inspection. LPA met with assistant Effie Greer. LPA was informed that licensee Alexandria Bunger is out of town and not available today. LPA asked if anyone else was present and was told two minor children ages 14 and 13 were also home today. All individuals subject to criminal background review have obtained a criminal record clearance. Today’s census was 1 infant and 5 preschool children. During the inspection two more school age children were picked for a total of 8 day care children.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the upstairs, laundry room, downstairs office and garage. Children may never enter these off-limit areas. LPA observed a working phone, and functioning smoke and carbon monoxide detectors. The fire extinguisher did not have a charge (indicator arrow was in the red zone labeled "empty".) Ms. Greer states this is the only fire extinguisher in the home. LPA observed weapons to be stored and locked separately from ammunition. Toxic and hazardous items (detergents, cleaning compounds, medications, sharp utensils, items that could pose a danger to children in care) are properly stored and inaccessible to children. The fireplace in the home is appropriately barricaded to prevent access by children. Stars were barricaded by a child safety gate. Safe toys and play equipment are observed. The outdoor play space is fenced. The backyard is fenced and gated. There is an above ground spa in the backyard which was observed covered and locked on all sides by a key lock. Some children’s files were reviewed. A current roster is being maintained. Licensee fire and disaster drills are conducted and documented last fire drill was on 1-17-20. CPR and first aid training were verified and expire 2021 . LPA discussed Mandated Reporter Training (AB 1207) which shall be renewed every two years.

Incidental Medical Services (IMS) policy was discussed. 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: http://www.ada.gov/childqanda.htm.
REPORT IS CONTINUED ON THE FOLLOWING PAGE LIC 809-C
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: BUNGER, ALEXANDRIA
FACILITY NUMBER: 313617066
VISIT DATE: 02/18/2020
NARRATIVE
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LPA verified the annual fees are current. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so the Licensee can request to be added to the distribution list to receive Quarterly Updates.

LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com. Licensee mandated reporter certificate expires on March 2021.

LPA discussed the new Safe Sleep in Child Care regulation and gave licensee the brochure. LPA discussed and provided the Effects of Lead Exposure brochure.

LPA reviewed and discussed this facility evaluation report with the Ms. Greer. LPA provided a Notice of Site Visit and the Ms. Greer acknowledges that this notice should remain posted for 30 days for parental review. LPA encouraged Ms. Greer to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.



In the areas that were evaluated during today's inspection, LPA observed the only fire extinguisher did not have charge and the red indicator stated "empty". LPA was told this is the only fire extinguisher available in the home. Thiis a Type A Title 22 deficiency. The deficiency has been cited on the attached LIC 809 D. Upon receipt of Type A citations, licensee shall post and provide copies of the LIC 809 D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 809 D in each child's file
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BUNGER, ALEXANDRIA
FACILITY NUMBER: 313617066
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/18/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/19/2020
Section Cited

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OPERATION OF A CHILD CARE HOME:The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal.
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This requirement was not met as evidenced by: LPA observed the fire extinguisher did not have a charge and the indicator arrow pointed to "empty" Ms. Greer stated this is the only fire extinguisher they have. This is an immediate risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:
DATE: 02/18/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/18/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3