394501175-1-9-2025-53-CC-CPRA-DCRR92-20250109114849

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394501175
Report Date: 01/09/2025
Date Signed: 01/09/2025 11:48:56 AM

Document Has Been Signed on 01/09/2025 11:48 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	NUNEZ, EMELY SULAY		FACILITY NUMBER:	394501175
ADMINISTRATOR/ DIRECTOR:	NUNEZ, EMELY SULAY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 612-6239
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95210
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	01/09/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Emely Sulay Nunez		TIME VISIT/ INSPECTION COMPLETED:	12:40 PM

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On 1/9/25, Licensing Program Analyst Carla Polanco (LPA) met with Applicant, Emily Sulay Nunez (A1) for the purpose of a pre-licensing inspection for a capacity of 14 children. LPA received proof of Large License qualifications prior to inspection. Fire safety Inspection Clearance was granted on 12/9/24 for a total capacity of (14) children. LPA disclosed the purpose of the inspection and was granted entrance into the Family Childcare Home (FCCH). LPA provided the Entrance Checklist to A1. All individuals subject to criminal background review have obtained a criminal record clearance verified by LPA1 accessing Guardian. A1’s tentative hours of care are Monday through Saturday, 24 hours per day.

A health and safety inspection was conducted inside and outside of the FCCH. A1 accompanied LPA for the entirety of the tour. The FCCH is a one-story house with a gated front yard, garage, living room, kitchen, family room, laundry area near the kitchen, bathroom #1, master bedroom #1, bathroom #2 located in the master bedroom, Bedroom #2, bedroom #3 and a backyard. LPA verified that toxic and hazardous items were inaccessible to children in care. LPA did not observe any stairs. LPA observed a fireplace in the living room which was properly barricaded. The outdoor play area was toured which includes the backyard which is both cemented and grass. LPA verified that the entirety of the backyard is fenced-in and walked the perimeter to ensure the safety of the fence and gate. LPA did not observe any pool, spa nor water feature.

A1 intend to use the gated front yard for the daycare children. A1 stated that she does not own any pets, but will be acquiring a small dog in the near future. LPA discussed safety precautions with children and pets.

The OFF-limits areas of the FCCH are the bedrooms, bathroom #2 located in the master, laundry area, kitchen, garage and the backyard. A1 understands that if she wants to make any Off-limits area an ON-limits area, she must notify Licensing and LPA must do an inspection BEFORE children are allowed in said area.

Continued on LIC809-C.......

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: NUNEZ, EMELY SULAY	FACILITY NUMBER: 394501175
	VISIT DATE: 01/09/2025

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A functioning smoke detector and a functioning carbon monoxide detector was tested in the living room. A fire extinguisher meeting tittle 22 regulations was observed in the kitchen, and a first aid kit was observed in the living room. A1 stated there are no firearms nor weapons in the home.

LPA discussed Mandated Reporter Training with A1. Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their Mandated Reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English and Spanish. A1 has a current Mandated Reporter Training Certificate which will expire on 05/2025. Current Pediatric CPR and First Aid training was verified and expires on 04/2025. Completion of Preventative Health and Safety training including nutrition and lead exposure was verified before the inspection. Proof of required immunization's for A1 was also verified before the inspection.

LPA discussed the Safe Sleep Regulations with A1 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 A1 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. LPA discussed the requirement to check and log infant napping every 15 minutes for infants under 24 months. LPA provided a copy of the LIC 9227, Individual Sleeping Plan, to be completed for or infants under 12 months.

Incidental Medical Services (IMS) policy was discussed with A1. 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Continued on LIC809-C.....

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: NUNEZ, EMELY SULAY	FACILITY NUMBER: 394501175
	VISIT DATE: 01/09/2025

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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. 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 communications.

Applicant, was 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.

A1 understands that licenses are not transferable, and once licensed, Licensee must live in the home and be present for 80% of the operating hours. A1 understands that if an unusual incident occurs; Licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report LIC 624 shall be submitted within 7 days to remain in compliance. A1 understands that if any structural changes are made to the FCCH; Licensing must be notified PRIOR to construction.

A1 understands that children’s and staff’s records are to be maintained according to Title 22 regulations and be accessible to Licensing for up to 3 years. LPA reviewed with Licensee 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. A1 understands that fire drills must be conducted and documented once every 6 months.

As of today, 1/9/25, A1 is approved for a Large Family Child Care Home license MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

An exit interview was conducted, and the report was reviewed with A1. Licensee Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025

LIC809 (FAS) - (06/04)

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