444407081-5-14-2019-07-CC-EBEN-BC6LBK-20190514083649

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444407081
Report Date: 05/09/2019
Date Signed: 05/14/2019 08:38:00 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	NUNEZ, YOLANDA		FACILITY NUMBER:	444407081
ADMINISTRATOR:	NUNEZ, YOLANDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 722-7317
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 4	DATE:	05/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Yolanda Nunez		TIME COMPLETED:	04:05 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	Licensing Program Analyst's (LPA) Elizabeth Berumen conducted an annual random inspection. LPA met with Licensee, Yolanda Nunez and explained the nature of today's inspection to her. LPA also observed 4 day care children, Licensee's adult daughter, Elizabeth Nunez and Licensee's mother, Auxilio Guerrero in the home during the inspection. Three preschool age children and one infant. Days and hours of operation are Monday - Friday from 6:00 AM to 6:00 PM. Licensee states there are four adults living in the home; herself, her spouse, two sons (Amilcar and Jonathan) and her daughter, Myriam. A review of staff records on May 8, 2019 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA inspected the indoor and outdoor on limit areas of the home today. The outdoor play area is fenced and was observed to be free from hazards. The storage shed is off limits to children. LPA observed barricaded stairs. Fire place in off limit living room area is screened. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. LPA observed a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, fenced backyard, and no bodies of water. The Licensee states that she does not have any weapons. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. LPA observed required postings near the facility entrance; including but not limited to the License to operate and Notification of Parents Rights (PUB 393). LPA reviewed current roster and fire disaster drill log; last practiced and documented fire/disaster drill was on April 23, 2019. Licensee has current CPR & First Aid, expiring on 02/23/2021. Licensee has immunization against pertussis and measles. Licensee completed the Mandated Reporter Training on April 16, 2018 and understands that the course is to be taken every two years.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: NUNEZ, YOLANDA	FACILITY NUMBER: 444407081
	VISIT DATE: 05/09/2019

NARRATIVE

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LPA discussed Lead Safety Information (AB 2370). Chapter 676, statues of 2018, requires all child care providers, upon enrolling or re-enrolling any child, to provide the parent or guardian with written information.

Safe Sleep was discussed: place infants on their backs when sleeping, use a firm sleep surface such as a mattress in a safety approved crib, keep soft bedding such as blankets, pillows, toys out baby's sleep area and ensure that pacifiers have nothing attached to them. LPA provided Yolanda Nunez with a safe sleep flyer.

LPA discussed with Licensee the violations that would result in an immediate assessment of civil penalty in the amount of $500. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, etc.

LPA requested an updated Application for family child care home (LIC279) to reflect adults living in the home. Licensee to mail to CCLD 2580 N. First Street Suite 300
San Jose CA 95131.

An exit interview was conducted in Spanish with Yolanda Nunez. A copy of this report was provided to the Licensee at the conclusion of the inspection.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

No deficiency cited.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019

LIC809 (FAS) - (06/04)

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