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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216060
Report Date: 02/25/2022
Date Signed: 02/25/2022 10:49:28 AM


Document Has Been Signed on 02/25/2022 10:49 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:NUNEZ FAMILY CHILD CAREFACILITY NUMBER:
566216060
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
02/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Lorena Nunez TIME COMPLETED:
11:00 AM
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On 2/25/22 at 8:42 am Licensing Program Analyst (LPA) MIchael Mathew and Licensing Program Manger (LPM) George Mingle Conduced an unannounced case management regarding increase of capacity and met with licensee Lorena Nunez. LPA and LPM toured the home inside and out, and there where 4 children ( 2 daycare children and 2 are licensee's own children) and one adult at the time of the visit. All adults in the home are fingerprinted and background cleared .

Licensee uses one bedroom one bathroom, living room, kitchen and backyard for care. The home has age appropriate toys and ample amount of space for children in care. Licensee states that there are no guns/ weapons/ or ammunition in the home.LPA observered no bodies of water in the home Knives are inaccessible to children. Chemicals are kept on top of the fridge and in the garage which is inaccessible to children. The required fire extinguisher 2a10bc was purchased on 9/12/2021 (receipt was not available upon request. Licensee stated she will send a copy of receipt to LPA.) Pediatric CPR and first aid will expire on 6/26/2022. Mandated reporter training will expire on 7/16/2022. LPA Observed Children file which are current and completed. There was one infant - C1, in care. LPA reviewed an Individual Sleeping Plan (LIC9227) on file. The home has 3 combination Fire alarm and carbon monoxide detectors, which were observed to be in the hallway and two bed rooms, fire alarm and carbon monoxide detectors were tested and found to be functional. Last Fire drill was conducted on 10/20/21.

Fire Clearance was granted by Ventura County Fire Department on 2/10/2022.

The facility is currently providing Incidental Medical Services for C2. An LIC9166 is in the child's file. Incidental Medial Services (IMS). LPA inspected the device and reviewed the Plan of Operation and discussed 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.

.Continued on 809-c


SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael MathewTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
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: 566216060
VISIT DATE: 02/25/2022
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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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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.

A capacity of 14 for a Large Family Child Care Home is granted effective 2/25/2022.

No deficiency were cites in todays visit.

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.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael MathewTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022
LIC809 (FAS) - (06/04)
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