325407984-9-29-2021-13-CC-KMAS-C7BTTB-20210929150027

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 325407984
Report Date: 09/29/2021
Date Signed: 09/29/2021 03:00:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	MUNGER,JULIANNA AND THOMAS FAMILY CHILD CARE HOME		FACILITY NUMBER:	325407984
ADMINISTRATOR:	MUNGER, JULIANNA & THOMAS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 310-1058
CITY:	QUINCY	STATE: CA	ZIP CODE:	95971
CAPACITY:	14	CENSUS:	DATE:	09/29/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Applicant, Julianna Munger		TIME COMPLETED:	03:00 PM

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	A change of location pre-licensing inspection was conducted today by Licensing Program Analysts (LPA), Kirk Marks and Bianca Mendez. The licensee is requesting a license for a capacity of 14 in her new residence. Services will be provided Mon-Fri 7:30am -5:30pm. The residence is a three bedroom, two and a half bath home. There are two adults and two minors living in the home. All adults residing in the home or working with children have criminal background clearances on file with the Department. Children will have access to the daycare room, kitchen, living room, dining room and one bathroom. The licensee understands any changes to the use of the home shall be reported to the Department with an updated floor/yard plan. The home is clean and orderly at this time and will remain so during child care hours. There is a working telephone. The sharp knives, cleaning supplies and medicines, are stored out of the reach of children. There are firearms and ammunition locked separately in the home. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector, carbon monoxide detector and fire extinguisher rated at least 2A10BC. Children will use the front yard as the outdoor play area and it is not fully fenced. The licensee understands that complete supervision is required when the children use the front yard as a play area. Poisons are not stored at the home. The licensee understands that items that could pose a danger to children shall be made inaccessible to children. There were no bodies of water observed. (continued on page 2)

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk Marks	TELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MUNGER,JULIANNA AND THOMAS FAMILY CHILD CARE HOME	FACILITY NUMBER: 325407984
	VISIT DATE: 09/29/2021

NARRATIVE

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The licensee is not providing Incidental Medical Services – IMS, at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. A Plan for Providing IMS must be submitted to the Department if IMS is provided. 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: www.ada.gov/childqanda.htm. The licensee possesses current pediatric CPR and First Aid certification. Licensee will complete updated mandated reporter training prior to being licensed at this facility. The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report was reviewed and discussed with the licensee. New Infant Regulations and Guide to Safe Sleeping Practices was discussed. Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk Marks	TELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2021

LIC809 (FAS) - (06/04)

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