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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019409
Report Date: 07/06/2021
Date Signed: 07/06/2021 12:29:19 PM

Document Has Been Signed on 07/06/2021 12:29 PM - 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NUNO VARGAS FAMILY CHILD CAREFACILITY NUMBER:
198019409
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
07/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Ana Nuno Vargas, LicenseeTIME COMPLETED:
12:35 PM
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Prior to entrance to the facility, LPA Mayra Rivera conducted a Covid 19 assessment and based on the licensee responses to the facility assessment questions, LPA Rivera determined safe to proceed. On Tuesday, July 6, 2021 at 9:36 AM, Licensing Program Analyst (LPA) Mayra Rivera conducted an annual inspection and met with Licensee Ana Nuno Vargas who guided LPA Rivera on a tour of the facility.

During the inspection, 7 children were present. LPA observed two school age children (licensee children) sitting in the kitchen area eating their breakfast. Four daycare children with licensee dancing and playing and one infant age 13 months sleeping in the crib. LPA observed the current children’s roster posted on the bulletin board with 7 children listed. Family members residing in the home are cleared and been discussed with licensee. Operating hours are Monday to Sunday, 12:00 AM to 11:59 PM and care for children ages 0 to 12 years.

This is a one story home which consists of 2 bedrooms, 1 bathroom (which connects to both bedrooms), kitchen, living room, front side yard (fenced), Per licensee and facility sketch areas off limits to children and parents include: 1 bedroom located by the living room and front yard .Per licensee, there are no dual licenses at this address.

At 9:35 AM LPA Rivera entered the daycare room area to inspect for safety, comfort, cleanliness, ventilation and working phone (land line). LPA observed a wall heater and with a fireproof cover anchored for heat safety. LPA also observed gas pilot light on. LPA observed a wall AC unit and the AC unit was on. LPA observed a cubby storage with children personal belongings, two other cubbies with children materials such as art supplies, puzzles, and manipulative. LPA observed the furniture and children materials to be in good condition and age appropriate. At 9:45 AM, LPA Rivera entered the restroom and observed the toilet, running water, hand soap and paper towels. LPA observed the bottom cabinets closed and with a child proof locks in place to make it inaccessible to children. LPA observed the restroom to be in good condition. LPA observed the safety latch on the cabinet above the toilet starting to become loose. LPA advised to replace the safety latch. At 9:54 AM LPA observed detergents, cleaning compounds items stored inside the bottom kitchen cabinet.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NUNO VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 198019409
VISIT DATE: 07/06/2021
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LPA observed the cabinets doors closed and with a safety latch in place to make it inaccessible to children. At 9:57 AM LPA observed two cleaning bottles hanging behind the door. LPA advised to place the bottles higher even though the preschool children can’t reach but school age children may be able to reach. LPA did not observe a fireplace. For drinking water, LPA observed individual personal water bottles filled with water and children having access to their water bottle.

The licensee understands that any poisons or firearms must be locked with a key or combination lock. LPA did not observed any pets.

At 10:00 AM LPA Rivera observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged and serviced on 10/14/19 LPA informed licensee the service on the fire extinguisher expired on 10/14/20 and the service is due or purchase a new required 2A10BC fire extinguisher and save the purchase receipt. At 10:02 AM LPA pressed on the carbon monoxide alarm located in the bedroom near the living room and observed the green light on. At 11:03 LPA asked licensee to press on the smoke alarm and LPA heard the sound of the alarm. LPA observed the first aid kit fully stocked and located in the restroom.

At 10:50 AM LPA inspected the outdoor area used by children in care for safety, comfort and cleanliness, LPA observed the side yard to be fenced all around and the sliding gate closed. The porch provides shade and LPA observed a playhouse, trike bikes, small basketball hoop and a cubby with toys. LPA observed play equipment to be in good condition and age appropriate.

LPA observed licensee pediatric First Aid/CPR certification (expired 03/6/2021). LPA Licensee has proof of immunization against pertussis, measles and influenza ( 6/9/21). The licensee has not completed the mandated reporter (AB 1207) and LPA guided licensee on where to enroll for the training www.mandatedreporterca.com. LPA informed that the mandated reporter training must be completed every 2 years.



At 11:05 AM LPA observed on the bulletin wall the facility sketch, pediatric first aid certification (expired), facility license, earthquake/fire drill log and emergency disaster plan. LPA did not observe earthquake or fire drills log.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NUNO VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 198019409
VISIT DATE: 07/06/2021
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The following was discussed: .

INFANT CARE: Licensee states currently has no infant in care. LPA Rivera reviewed and discussed Safe Sleeping Practices information with licensee and a plan for supervising sleeping infants. LPA advised the licensee to sleep infants in an area where infants can be directly supervised. Place infants on their backs to sleep, on a firm mattress with fitted sheet that fits snugly in crib or play yard. LPA also advised against sleeping infants in a separate room with no direct supervision and no pillows, crib bumpers, swaddling, head covered, and pacifiers must not have anything attached. Safe sleep brochure was provided.

LPA Rivera also reviewed Sudden Infant Death Syndrome (SIDS), Never Shake A Baby, and Lead Exposure information with licensee.. LPAs also explained to licensee that car seat, stroller are only and only for transportation, high chair is only and only for feeding and stated items cannot be misused. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.


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: http://www.ada.gov/childqanda.htm

LPAs advised the licensee how to access forms, regulations and quarterly updates , and Providers Information Notices (PIN) on line at: www.ccld.ca.gov




LPAs issued the Confidential Names List (LIC 811) to the licensee during this inspection. The Confidential Names List documents the children’s and staff files that were reviewed during this inspection.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NUNO VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 198019409
VISIT DATE: 07/06/2021
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Licensee has been given an advisory notice to obtain current Pediatric First Aid/ Infant-Child-Adult CPR certification, AB 1207 Child abuse mandated report certification, earthquake and fire drills and service or purchase a new 2A10BC fire extinguisher. No citations being issued today. Licensee has been given until July 16, 2021 to completed and submit the above documents.

Exit interview was conducted and plans of correction were reviewed and developed with Licensee, Ana Nuno Vargas. Appeal rights explained & provided. A copy of this report and appeal rights were discussed and left with licensee, Ana Nuno Vargas whose signature on this form confirm receipt of these documents

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2021
LIC809 (FAS) - (06/04)
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