313617066-1-10-2023-03-CC-ABLI-CMXP2L-20230110095608

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313617066
Report Date: 01/10/2023
Date Signed: 01/10/2023 09:56:16 AM

Document Has Been Signed on 01/10/2023 09:56 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	BUNGER, ALEXANDRIA		FACILITY NUMBER:	313617066
ADMINISTRATOR:	BUNGER, ALEXANDRIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 899-9603
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	14	CENSUS: 3	DATE:	01/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Effie Greer Roberts		TIME COMPLETED:	10:15 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) Amanda Blesi met with assistant provider Effie Greer Roberts. LPA was informed licensee, Alexandria Bunger, is out of state at this time and is not available. Also present were three day care children ages 2, 2, and 3 years old and assistant provider's own child who is over age 10. At 8:45 a.m., LPA toured the facility, and a health and safety inspection was conducted in all areas accessible to children. Off-limits areas include backyard, downstairs office, laundry room, the entire upstairs, and garage. Assistant provider acknowledged that children must never enter these areas. LPA observed the required postings, a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors which are hard wired to the Lincoln Fire Department. Per assistant provider, there are no weapons in the home. There is an above ground spa located in the off limits backyard. The spa was observed covered and locked on all sides. Toxic and hazardous items are inaccessible to children. Fireplace is barricaded to prevent access by children. Stairs were barricaded to prevent access when children under 5 are present. Outdoor play space is fenced. Licensee states no new residents have moved into the home since the last inspection. 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. A current roster is being maintained and fire and disaster drills are documented. Last fire drill was conducted on December 9, 2022. Current CPR and First Aid certification was verified for assistant provider (3/2024) and licensee's expires 4/1/2024. LPA observed AB1207 Mandated Reporter Certificates for assistant and licensee are good until 3/2024. (Report continues LIC809-C)

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BUNGER, ALEXANDRIA	FACILITY NUMBER: 313617066
	VISIT DATE: 01/10/2023

NARRATIVE

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No infants were present during today's inspection.
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

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided an updated Plan of Operation that includes 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

Title 22 Deficiencies are cited on the following page: LIC 809-D.

Exit interview conducted and report was reviewed with the facility representative Effie Greer Roberts. Appeal Rights given.
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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/10/2023 09:56 AM - It Cannot Be Edited

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: 01/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(a)

Operation of A Family Child Care Home

(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, , the licensee did not comply with the section cited above when licensee, Alexandria Bunger, has not been present in her facility 80% of operating hours per day. LPA has made six separate facility inspections since 2020 where Ms. Bunger has been “out of town” or not present. Day care assistant, Effie, reports Ms. Bunger frequently goes out of state to help her family members. Additionally, children state Ms. Bunger has moved and no longer lives in the home and they only see her, “sometimes, or a little bit”, and that Ms. Effie is the one who cares for them at day care. Day care assistant, Effie, her husband, James Roberts and their children live at the facility and it is unknown if licensee still resides at this address. If not corrected, this could pose/poses a potential risk to the health and safety of children in care
	POC Due Date: 02/10/2023
	Plan of Correction
1 2 3 4	A plan of correction could not be discussed with licensee, Alexandria Bunger, because she was not present during today's inspection. Licensee shall contact LPA via email @ Amanda.blesi@dss.ca.gov or PH: 916.208.3427 to discuss if she would like to maintain her license. To correct the deficiency, LPA will make a return inspection to determine if licensee is present 80% of her operating hours, per day, and living in the home. If not corrected, civil penalties may be assessed

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

LIC809 (FAS) - (06/04)

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