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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629652
Report Date: 06/14/2023
Date Signed: 06/14/2023 12:05:34 PM

Document Has Been Signed on 06/14/2023 12:05 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:JOURDAIN, BLEEKER & NEMETH, STEPHANIE FCCFACILITY NUMBER:
376629652
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
06/14/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Bleeker Jourdain & Stephanie Nemeth TIME COMPLETED:
11:45 AM
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On June 14th, 2023, at 9:40 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a pre-licensing inspection with Applicants Bleeker Jourdain & Stephanie Nemeth. The inspection’s purpose is to ensure that the home follows standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. Present in the home were the Applicants and two (2) children, under the age of 10 years. This four (4) bedroom, two (2) bathroom house was toured and inspected. The daycare operational schedule will be weekdays 8 AM to 5:30 PM.

The Applicants shall submit an updated application to the Licensing Department should the daycare operational schedule change. The Applicant understands that they will need to notify the Department of any changes to the childcare areas and obtain departmental approval before use of any new childcare areas not previously licensed. Applicants will use the following areas for childcare: the living room, one (1) bathroom and one (1) bedroom. The off limits areas include the kitchen, remaining bedrooms and remaining bathroom. Access into the kitchen is barred by use of a child safety gate. Access into the remaining bedrooms and bathroom is made inaccessible by use of door locks. There are no bodies of water observed during time of visit. The fire extinguisher is rated 2A 10B: C. and is located in the kitchen. The smoke and carbon monoxide detectors meet requirements and are operational. Poisons, detergents, cleaning compounds and medications are secured inaccessible to children in care by placement in a locked kitchen cabinet; the kitchen has a safety gate barring children’s access in this area. Children’s toys and play equipment are available. The Applicants have working telephones/cell phones. The Applicants agreed to notify licensing should their telephone numbers or email addresses ever change. The Applicants indicated there are no firearms or other weapons in the home. The Applicants also reported that no animals/pets live in the home.

The Applicants intends to conduct outdoor activities in the fenced and shaded backyard. The Applicants acknowledges continuous, visual supervision shall be given whenever children are engaged in outdoor activities. The Applicants intends to occasionally transport the children in their own vehicle. The Applicants
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2023
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JOURDAIN, BLEEKER & NEMETH, STEPHANIE FCC
FACILITY NUMBER: 376629652
VISIT DATE: 06/14/2023
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shall transport children in rear seats in appropriate child passenger restraint systems which meet applicable federal motor vehicle safety standards. The Applicants acknowledges that car seats shall only be used for transportation purposes and shall not be used for sleeping. The Applicants acknowledges children shall never be left unattended in the daycare vehicle. The Applicants further confirms maintenance of the daycare vehicle shall be upheld to ensure safety.

Applicants maintains documentation of proof of control of property for review by the Department. Applicants have completed the preventative health and lead poisoning prevention courses. The Mandated Reporter training was completed on 01/05/2023 and 01/15/2023. Applicants acknowledge they will have to redo the Mandated Reporter Training once every two (2) years. Pediatric CPR and First Aid certifications expire on 01/14/2025 and 04/19/2025. Applicants acknowledge they will need to renew their pediatric CPR and First Aide certifications before their expiration dates. The Applicants and adult residents in the home have criminal record clearances and/or exemptions on file. Applicants were reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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. The Applicants were advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon their 18th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and comply.

LPA discussed the safe sleep regulations with the Applicants 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 applicant 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. 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

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JOURDAIN, BLEEKER & NEMETH, STEPHANIE FCC
FACILITY NUMBER: 376629652
VISIT DATE: 06/14/2023
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Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reviewed with Applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

The Applicants were also informed the following items are prohibited during day care operating hours: walkers, exersaucers, jumpers, inclined sleepers, and bouncy seats. Corporal punishment and smoking are not allowed in the day care.

Applicans and LPA reviewed the ratio/capacity worksheet. LPA discussed the maximum capacity for a small family childcare home: four infants only (infants mean any children under 24 months); or six children with no more than three infants; or, with landlord consent, eight children with no more than two infants, one child in kindergarten or elementary school and one child at least age six, including children under age 10 who live in the home. Landlord consent is on file.



The Applicants states they are financially secure to operate a family childcare home for children. The Applicants agree to comply with all regulations and laws governing family childcare homes.

Applicants were advised that any agent of the Licensing Department upon presentation of proper identification, may enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice. The Applicants shall permit the Department to inspect the family childcare home, and to privately interview children or adults, to determine compliance with or to prevent violations of family childcare laws or regulations. Applicants were advised that the Department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation, if the Applicants refuses any agent of the licensing Department entry into the daycare or any part of the daycare.

LPA informed Applicants that the failure of a Licensee to pay all applicable and accrued fees and/or civil penalties shall constitute grounds of forfeiture of the daycare license.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JOURDAIN, BLEEKER & NEMETH, STEPHANIE FCC
FACILITY NUMBER: 376629652
VISIT DATE: 06/14/2023
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To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Applicants' email addresses were enrolled in the Department’s email notification program update system; final completion is pending Applicants' electronic confirmation of their email addresses.

No corrections are needed. A small license is issued effective today (06/14/2023). The new license will be mailed to the Applicants when available.

Exit interview conducted and report was reviewed with the Applicants Bleeker Jourdain & Stephanie Nemeth.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
LIC809 (FAS) - (06/04)
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