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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406213817
Report Date: 09/09/2021
Date Signed: 09/09/2021 12:11:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:NUSSER-RAINS FCC AKA MINDY'S DAY CAREFACILITY NUMBER:
406213817
ADMINISTRATOR:MINDY NUSSER-RAINSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 704-9792
CITY:TEMPLETONSTATE: CAZIP CODE:
93465
CAPACITY:14CENSUS: 9DATE:
09/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Mindy NusserTIME COMPLETED:
12:10 PM
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On 9/9/2021 @ 10:20 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced annual required inspection. LPA asked Licensee of pre- screening questions related to COVID-19, Licensee's responses to the pre-screening questions suggest no COVID-19 exposure on site. LPA met with Licensee and assistant and discussed the purpose of the inspection. There were 9 children present, 3 of whom were infants. During the inspection, Licensee dropped off 2 school age children, and picked up 2 school age children from the nearby elementary school. Licensee ensures that Staffing Ratio and Capacity is observed and implemented.

LPA toured the interior and exterior of the day care. LPA observed required licensing forms are posted in the Family Child Care Home (FCCH). LPA observed smoke and carbon monoxide detectors in the FCCH. The regulation fire extinguisher was serviced on January 21, 2021. Home conducts and documents fire and disaster drill every month The most recent fire/disaster drill was conducted last 8/18/2021. The bathroom was inspected and observed to be clean and free of toxin. LPA observed the day care is clean and free of hazardous items. Guns and ammunition are locked in two separate vaults.

The backyard is enclosed by wooden fence. LPA observed age appropriate toys and play equipment. No bodies of water were observed on site.

LPA Reyes reviewed facility file, Pediatric CPR and First Aid expires on 6/23/2022. Licensee and Assistants record of immunization per SB 792 are complete.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: NUSSER-RAINS FCC AKA MINDY'S DAY CARE
FACILITY NUMBER: 406213817
VISIT DATE: 09/09/2021
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LPA discussed Safe Sleep Regulations with Licensee. Providers must check on sleeping infants (0 to 24 months) every 15 minutes and document their condition to check for signs of distress, which includes, but is not limited to labored breathing, flushed skin color, increase in body temperature, and restlessness. Each infant, up to 12 months of age, must have an Individual Infant Sleeping Plan (LIC 9227) on file, which will document the infant's sleeping habits, usual sleep environment, and the infant's rolling abilities.

The Licensee is not providing 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: www.ada.gov/childqanda.htm

Exit interview conducted with Licensee Mindy Nusser. Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing

In the areas evaluated, no deficiencies observed.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
LIC809 (FAS) - (06/04)
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