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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002954
Report Date: 07/07/2022
Date Signed: 07/07/2022 11:25:38 AM

Document Has Been Signed on 07/07/2022 11:25 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BESSY B. LUNAFACILITY NUMBER:
384002954
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
07/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Bessy LunaTIME COMPLETED:
11:45 AM
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Licensing Program Analyst, LPA Yee conducted a required 1-year inspection today. The purpose of the inspection was explained. Present at the daycare are licensee Luna, her helper, and 3 daycare children (2 infants). Luna Bessy is the only person who lives in this home. Day-care areas: living room #1, living room #2, kitchen, bathroom, side yard and bedroom for napping. The bedroom was requested to add for napping only during the inspection. LPA inspected and approved. The remaining areas of the house are off-limits.
During the visit, LPA observed two saucer chairs in the daycare areas. LPA explained the regulations and the licensee remove the saucer chairs during the visit.
The facility is equipped with a 2A10BC fire extinguisher, smoke detectors, and carbon monoxide. CPR, 1st aid certificate is current until 4/17/2023. An emergency drill was conducted once every 6 months. A log sheet was available. The facility has age-appropriate toys and equipment for the children.
LPA reviewed 3 children's files. LIC9227 is missing in one of the files. LPA explained to Luna that an infant who is less than 12 months old needs to have LIC9227 completed by the child's representative. A blank form was provided. During napping, the infant needs to be check every 15 mins and keep a log sheet. Luna said she does check the infants every 15 mins, but did not keep a log sheet.
LPA discussed the safe sleep regulations with the licensee 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 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.
Licensee has current AB1207 certificate on file. However, the helper needs to take the class and keep the certificate on file.
LPA discussed Child Abuse Mandated Reporter Training AB1207 with Licensee. As of January 1, 2018, all staff will be required to complete Child Abuse Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.
The annual fee is past due. A copy of the fee statement was provided during the visit..
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2022
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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