406215055-10-7-2019-17-CC-MKST-BGQTLF-20191007144927

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215055
Report Date: 10/07/2019
Date Signed: 10/07/2019 02:49:36 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:	NUNEZ FAMILY CHILD CARE		FACILITY NUMBER:	406215055
ADMINISTRATOR:	MARGARITA NUNEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 927-5529
CITY:	CAMBRIA	STATE: CA	ZIP CODE:	93428
CAPACITY:	14	CENSUS: 10	DATE:	10/07/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Karley Nunez		TIME COMPLETED:	02:45 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	(1) Licensing Program Analysts (LPAs) Melissa Stewart and Elvin Baddley conducted an unannounced annual/random inspection and met with licensee, Karley Nunez. Also present in the home was Licensee Margarita Nunez and both spouses of licensees. The home was toured inside and out. All required forms are posted in a prominent location. There were 10 children present, 3 being infants. This is a 2 bedroom and 1 bath home. The living room and kitchen are used for day care. The two bedrooms are off limits areas which are made inaccessible to children with child proof door knob locks. LPAs observed knives in the kitchen drawer. As the drawer does not have a child proof lock, the knives were accessible to children. LPA observed licensee move the knives to the top of the refrigerator during the inspection. LPAs observed age appropriate toys and books and sleeping cots. Two infants were awake in swings and the remaining children were laying on cots at the time of inspection. Licensee stated that the infants are moved to mats when they fall asleep and are not permitted to sleep in the swings. In the bathroom used by children, LPA observed hygiene products labeled "keep out of reach of children" which were accessible to children. LPA observed licensee move the items out of reach of children during the inspection. Cleaning products are stored in the cabinet under the sink which is made inaccessible by a child proof lock. Licensee ensured that all hazardous items were stored inaccessible to children prior to the completion of the inspection. Licensee stated there are no guns or ammunition in the home. The deck and backyard are off limits to day care children. Licensee stated that the kitchen door which leads to the deck is kept locked at all times. There are no bodies of water. Cont. on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2019

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: NUNEZ FAMILY CHILD CARE	FACILITY NUMBER: 406215055
	VISIT DATE: 10/07/2019

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Fire extinguisher was serviced on 4/4/19. Carbon monoxide and smoke detectors were tested and operational. Licensee stated that emergency drills are held once per month.
Both licensees, Margarita Nunez and Karley Nunez, are current with CPR and first aid which expires on expires on 9/2020. Both licensees have met the immunization requirement per SB 792. Licensee informed LPA that one of the infants present in care began attending on 9/30/19 and that the child's parent has not returned the required emergency information or the signed Parent's Rights notification form.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPA reviewed and provided Licensee with a copy of “Child Care Providers Guide to Safe Sleep.” LPA provided “Effects of Lead Exposure” to be distributed to all families. Licensee was advised to review Quarterly Updates and Provider Information Notices (PINs) which can be accessed on-line at www.ccld.ca.gov.

See LIC 809-D for cited deficiencies in accordance with the California Code Regulations Title 22, Division 12. Appeal rights provided. An exit interview was conducted and Plans of Corrections were reviewed and developed with the Licensee. A copy of this report and appeal rights were discussed and left with Licensee, Karely Nunez, whose signature on this form confirm receipt of these documents.

LPA observed Licensee post the Notice of Site visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2019

LIC809 (FAS) - (06/04)

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