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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700514
Report Date: 11/03/2022
Date Signed: 11/03/2022 10:36:23 AM

Document Has Been Signed on 11/03/2022 10:36 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:NUNEZ & ALMAZAN FAMILY CHILD CAREFACILITY NUMBER:
197700514
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
11/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:31 AM
MET WITH:Adriana Nunez and LauraTIME COMPLETED:
10:50 AM
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On 11/ 3/2022, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required 1-Year inspection at the Nunez Family Child Care. Upon arrival, the LPA met with The licensee, Adriana Nunez who guided the LPA on a tour of the facility. Family members residing in the home include three adults ( licensee, licensee spouse, and licensee’s mother) and 2 child (Adriana's daughter 6 years old and infant 1 month). Per LIS, facility annual fees are current. Per The licensees, Days/Hours of Operation are Monday through Friday 23 hours. There were 7 daycare children present during this inspection. Incidental Medical Services (IMS) were discussed. Pre-licensees, the facility does not do IMS needs.
The Home is set up as follows:
This is a single-story 3 bedroom, 2-bathroom home with kitchen, family room (living room #2), living room #1, playroom, and garage. There is an in-ground pool and pond (body of water) on the premises. The garage is used for storage only and no childcare activities are conducted there. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.
Ø Main Area: Main care is provided in the living room #1 and #2 at the entrance. Children use the bathroom in the hallway.
· Living Rooms 1 and 2: In the areas, LPA observed a fireplace that was properly screened via a mirror glass barrier which made it inaccessible to children. LPA observed age-appropriate toys and furniture for the children. LPA observed: A small table was observed with a total of eight chairs. Several plastic storage bins were observed in which games and toys are stored for the children. A small play kitchen was located by the window with which children can play. There are games and books on the premises of this facility.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: NUNEZ & ALMAZAN FAMILY CHILD CARE
FACILITY NUMBER: 197700514
VISIT DATE: 11/03/2022
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· Children's Bathroom (#1): Children use the bathroom next to the left side of the hallway. The Bathroom was toured and inspected sink/toilet is in operable condition. Toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet and drawers. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
· Backyard: The home has an in-ground pool, jacuzzi, and in-ground pond in the backyard (photos in the file). The pool fencing is in Regulation (5 feet high, 4 inches spacing between bars, 2 inches from ground-cement). There are two gates each self-closing and self-latching, the wrought iron fencing for the pool is from one end of the pool to the other end (fenced completely). One gate opens inside the pool area and the other opens outside of the pool area. The backyard is completely fenced (brick wall), shaded area and a patio. There are plants and two sheds that are key-locked. The play area is clear and clean of debris, the play area is fenced and gated all around. The air conditioner is located on the left side of the patio without a cover. Licensees are reminded to supervise children at all times while at play in the backyard. The licensees stated the front yard will be used as well. The front yard is gated (wrought iron) and has a gate for the driveway. The licensees are reminded to supervise children at all times while at play in the front yard.
· Off-limit: Off-limit areas include Bedroom #1,#2, #3 and Kitchen/Dining Room: The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). In the kitchen, all sharp utensils, poisons, and medications are made inaccessible to children with child safety latches on cabinet doors and drawers. sharp knives in the upper kitchen cabinet above the range, bathroom #2, and the garage (laundry inside).
Ø Others:
· AC/Heating Unit was observed. AC/Heating Unit is located on the left side of the home without a cover
· Bodies of water: LPA observed an in-ground pool in the facility. There is a fence at least five feet high and the fence does not obscure the pool from view. The gates swing away from the pool, self-close, and have a self-latching device located no more than six inches from the top of the gate.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged. and located in the living room inaccessible to children. It meets standards established by the State Fire Marshall.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: NUNEZ & ALMAZAN FAMILY CHILD CARE
FACILITY NUMBER: 197700514
VISIT DATE: 11/03/2022
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· Fireplace: The fireplace was observed in the off-limits Family room and is screened.
· Hanging window blind cords: The cords are inaccessible to children.
· Incidental Medical Services (IMS): 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The licensees will not be providing IMS to the children at this time.
· Isolation area (Illness): Per The licenseess, if the child shows signs of illness, he/she will be separated from other children and stay in Family room.
· Medications and cleaning solutions: Detergents/cleaning compounds are under the kitchen sink with a child locked. medicines (tight-fitting container in the upper kitchen cabinet)
· Napping: Children will nap in the designated nap areas with adult supervision. Children nap on cots and playpens
· Pets: 2 dogs (1 big and 1 small). They have current vaccinations.
· Phone service: There is a working landline or cell phone
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· The First Aid kit is located in the key-locked closet inaccessible to children. The First Aid Kit was observed complete with supplies and a first aid manual.
· Transportation: The licensees do provide transportation for children. The licensee has a valid California driver's license with an expiration date of 06/5/2026. The licensee has valid vehicle insurance with an expiration date of 03/04/18 and a vehicle registration dated 3/8/23.
· Weapons or Firearms: Per Licensee, there are no Firearms at the facility at this time. LPA does not observe any firearms.

Ø Documentation:
· Child files: LPA reviewed 8 children's records, the records are incomplete and missing forms. Children do not have their IZ records in the file.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: NUNEZ & ALMAZAN FAMILY CHILD CARE
FACILITY NUMBER: 197700514
VISIT DATE: 11/03/2022
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· CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with an expiration date (04/23) of 1 hour of nutrition training, and (8) hours of Preventive Health and Safety Training.
· Facility Roster: LPA observed Child Care, Facility Roster. Per Licensing Information System, facility annual fees were current.
· Fire Drill and Disaster Drill: Per The licensees, fire and disaster drills are conducted every months; the last drill was documented and conducted on 10/2022.
· Immunization: The licensees have the required immunizations. The licensees provided a written statement declining the influenza vaccination.
· Infant Sleeping Plan (LIC 9227): LPA shared the information with The licensees. Per Licensee, there is NO infant (0-12 months) enrolled in the facility.
· The licensees have posted as required the Facility License, Emergency Disaster plan, and Parents' Rights Poster. The facility roster is current.
· Mandated Reporter Training: The licensees have completed the online mandated reporter training at www.mandatedreporterca.com and will renew on 10/6/23
Ø The following information was discussed with The licensees:
ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The licensees are reminded that 100% supervision is required for children at all times.
ü Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensees were reminded that supervision is always required for children in care.
ü The licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensees were advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.
ü The licensees were advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: NUNEZ & ALMAZAN FAMILY CHILD CARE
FACILITY NUMBER: 197700514
VISIT DATE: 11/03/2022
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ü The licensees were informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
ü Criminal Record Statement: Licensee [or facility representative] 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 the 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.
ü Safe Sleep: LPA discussed the safe sleep regulations with The licensees [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed The licensees [facility representative] 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.
ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
ü Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
ü Type A citation: LPA (name of analyst) informed licensee [or facility representative] (include name) that this report dated (insert visit date) document(s) (number of Types A citation) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA (name of analyst) informed The licensees [or facility representative] to provide a copy of this licensing report dated (insert visit date) that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
ü The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family daycare home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: NUNEZ & ALMAZAN FAMILY CHILD CARE
FACILITY NUMBER: 197700514
VISIT DATE: 11/03/2022
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ü --Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations.
n Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

ü A copy of the Safe Sleep Proposed Regulations was provided to Licensee.

ü LPA provided consultation during the inspection.

Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.



An exit interview was conducted and the report was reviewed with The licensees Adriana Nunez and Laura Almazan.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/03/2022 10:36 AM - It Cannot Be Edited


Created By: Carol Heath On 11/03/2022 at 10:16 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: NUNEZ & ALMAZAN FAMILY CHILD CARE
FACILITY NUMBER: 197700514

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above, LPA observed AC unit does not have a cover, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2022
Plan of Correction
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The licensee will sent pictures to the LPA
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above, LPA observed children's file. No IZ records were founded in the child's file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/11/2022
Plan of Correction
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The licensee will email LPA the IZ record.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022


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